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Pharm I exam review NUR210 Flashcards | StudBud
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Pharm I exam review NUR210
Pharm I exam review NUR210
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1
A nurse is caring for a patient on valproic acid. The patient reports
tremors
and
confusion
. What should the nurse do?
Administer a dose of folic acid to the patient
Assess the patient's liver function tests
Notify the healthcare provider about the possible signs of toxicity
Ask the patient to rest and monitor for other symptoms
2
A nurse is assessing a patient on alprazolam for anxiety. Which of the following side effects is most common?
Drowsiness or sedation
Hyperactivity
Weight loss
Increased energy
3
Which statement by the nurse is correct about synergistic drug effects?
A greater effect is achieved when two drugs are combined
Two drugs have antagonistic effects on each other.
The action of a drug is nullified by another drug.
One drug acts as an antidote to the side effects of another drug.
4
A client is with valproic acid (Depakote) for seizure. The therapeutic range for valproic acid?
20-40 mcg/mL
100-150 mcg/mL
50-100 mcg/mL
150-200 mcg/mL
5
A patient with epilepsy is taking gabapentin to control seizures. Which of the following should the nurse emphasize ?
"It is okay to skip a dose if you forget to take it in the morning."
"You should take the medication only when you feel a seizure coming on."
"It is safe to stop the medication if you feel better."
"You should continue taking it , even if you don’t have seizures."
6
The patient asks the nurse how to dispose of old medications. What should the nurse tell? (Select all that apply.)
Remove personal information from the bottle.
Throw bottle of medications into the trashcan.
Add water and crush drugs before disposing.
Mix old drugs with cat litter before disposing.
none
Flush the medications down the toilet.
7
A patient is prescribed lorazepam. What does the nurse know to be true regarding lorazepam?
It has a maximum adult dose of 25 mg/day.
causes plasma levels to be decreased when combined with cimetidine.
It is used to treat anxiety, status epilepticus, insomnia, , sedation
It interferes with the binding of dopamine receptors.
8
A patient refuses to take the prescribed medication. Which is the nurse’s best response to this patient?
Persuade the patient to take the medication.
Leave the medication at the patient’s bedside.
Tell the patient there is no choice in the matter.
Explain the benefits and side effects of the drug.
9
The nurse is assessing a patient for serotonin syndrome. Which of the following findings is most indicative?
Constipation and dry mouth
Drowsiness and confusion
Hyperreflexia and agitation
Bradycardia and hypotension
10
A nurse is preparing methylphenidate for a 6-year-old child with ADHD. Which of the following would be most important?
The child’s hearing and vision status
The child’s weight and height
The child’s blood glucose levels
The child’s ability to perform activities of daily living
11
What are the symptoms of EPS?
Hypertension
Nausea and vomiting
Hyperthermia and dysrhythmias
Tremors, rigidity, and shuffling gait
12
The nurse is monitoring a patient on fluoxetine. Which side effect should be monitored closely?
Increased appetite
Sexual dysfunction
Constipation
Rash
13
A patient is taking
Ritalin
(methylphenidate) and is prescribed an antidepressant (MAOI) What is risk ?
Increased sedation
Increased risk of serotonin syndrome
Decreased therapeutic effect of methylphenidate
Increased risk of hypotension
14
Which drug orders are complete? (Select all that apply.)
Artificial tears BID
Multivitamin sustained
Promethazine 25 mg STAT
Ciprofloxacin 500 mg PO tid
Vitamin D PO
Aspirin 81 mg PO daily
15
A nurse is caring for a patient on lorazepam. The patient suddenly develops confusion, slurred speech, and hypotension.
Reassure the patient and continue monitoring
Administer naloxone
Increase the dose of lorazepam to address the anxiety
Withhold the next dose of lorazepam and notify the healthcare provider
16
What information is essential for the nurse to document when giving drugs? (Select all that apply.)
Document the patient’s response to the drug.
Document all drugs given by the end of a shift.
Document the date, time, and dose drug is given.
no need to document
Document the correct site of an injectable drug.
Document the blood pressure before giving a drug.
17
Which adverse reaction from aspirin should the nurse teach the patient to report to the health care provider?
Tinnitus
Palpitations
Sinusitis
Weight loss
18
What should the nurse encourage the patient to do when teaching a patient who is receiving allopurinol?
Take medication 2 hours before meals.
Have annual eye examinations.
Increase vitamin C intake.
Eat more meat.
19
Which are common reasons for nonadherence to the drug regimen in an older adult? (Select all that apply.)
Impaired memory
Increased visual acuity
Decreased dexterity
Taking multiple drugs at one time
20
A patient who is taking trazodone for depression reports feeling lightheaded when standing up. The nurse should:
Withhold the medication and contact the healthcare provider immediately.
Recommend that the patient increase fluid intake to prevent dehydration.
Instruct the patient to take the in the morning to reduce dizziness.
Suggest the patient rise slowly from sitting or lying to avoid dizziness
21
A nurse is teaching a patient on lidocaine hydrochloride topical cream for pain. Which needs further teaching?
"I should not apply the cream to broken skin or open wounds."
"I should wash my hands thoroughly after applying the cream."
"I can use this cream as needed for pain relief throughout the day."
"I will avoid rubbing the area after applying the cream."
22
When a 12-year-old child is prescribed methylphenidate, which is most important for the nurse to monitor?
Temperature
Intake and output
Respirations
Height and weight
23
The nurse will question the provider if a drug with a half-life ( t ½) of more than 24 hours is ordered to be given?
Twice weekly
Every other day
Once weekly
Once daily
24
Which of the following interventions should the nurse prioritize after administration of midazolam for a procedure?
Encourage the patient to drink fluids.
Ambulate the patient as soon as possible.
Monitor for signs of respiratory depression.
Provide the patient with a light snack.
25
A client on lithium reports nausea, vomiting, and diarrhea. What should a nurse do for potential lithium toxicity?
Prepare to administer activated charcoal.
Monitor the client's serum lithium levels.
Encourage the client to drink fluids.
Notify the healthcare provider.
26
A client taking is on (SSRI) for depression reports very anxious and restless. The nurse is concerned about what ?
Tardive dyskinesia
Neuroleptic malignant syndrome
Hypertensive crisis
Serotonin syndrome
27
Which complementary and alternative therapy interactions may cause serotonin syndrome? (Select all that apply.)
Ma huang
Feverfew
Ginkgo biloba
St. John’s wort
28
Which of the following side effects should the nurse be most concerned about when a patient is receiving morphine?
Constipation
Nausea
Dizziness
Respiratory depression
29
The nurse should monitor the patient receiving phenytoin for which adverse effect?
Hypertension
sinusitis
Psychosis
Gum hyperplasia
30
A nurse is caring for an older adult patient on zolpidem. Which of the following nursing interventions is most important
Encourage the patient to take zolpidem during the daytime
Assess the patient for dizziness, confusion, or memory problems
Advise the patient to take zolpidem with a heavy meal to enhance effect.
Instruct the patient to increase fluid intake to prevent dehydration.
31
A client is receiving levetiracetam (Keppra) for seizure. What should be of the following is most important?
Assess for any signs of liver dysfunction
Ensure the client maintains a high-protein diet
Monitor the client’s blood pressure regularly
Educate the client about the risk of suicidal thoughts and behaviors
32
For foods rich in potassium, What is the nurse’s best recommendation of foods to consume?
Brown rice and fish
Cabbage and corn
Avocados and mushrooms
Bread and cheese
33
A patient is receiving aripiprazole, nurse include in the patient’s care plan? (Select all that apply.)
Administer before meals on an empty stomach to facilitate absorption.
Observe the patient for acute dystonia, akathisia, and tardive dyskinesia.
Remain with the patient until the medication is swallowed.
Assess the patient for evidence of neuroleptic malignant syndrome.
Monitor vital signs to detect orthostatic hypotension.
34
A patient is experiencing facial grimacing, involuntary upward eye movement, and muscle spasms of the tongue.
Tardive dyskinesia
Acute dystonia
Pseudoparkinsonism
Akathisia
35
What is a seizure involving generalized contraction of the body followed by jerkiness of the arms and legs?
Absence
Psychomotor
Tonic-clonic
Myoclonic
36
A patient has laboratory values of valproic acid of 150 mcg/mL What should the nurse do?
Hold the morning dose but give the other scheduled dosages for the day.
Ask the patient if he or she is having any adverse effects
Hold the medication and notify the health care provider.
Increase the daily dose so the patient’s level is in the therapeutic range.
37
A patient taking amitriptyline for depression reports feeling dizzy when standing. What is the nurse's best response?
"This may be a sign of orthostatic hypotension; try to rise slowly.
"You should increase your fluid intake."
"You may need to stop taking the medication immediately."
"This is a common side effect; you should continue the medication."
38
When developing an effective medication teaching plan, which component will the nurse identify as most essential?
Written instructions
The patient’s readiness to learn
A review of community resources
Use of colorful charts
39
The nurse knows that which drug is used to treat narcolepsy?
Modafinil
Phendimetrazine
Atomoxetine
Lisdexamfetamine
40
A patient is taking a sedative-hypnotic medication. What is the appropriate instruction the nurse should provide?
"Avoid alcohol and other CNS depressants."
"It’s safe to use this medication with over-the-counter sleep aids."
You can stop the medication if you don’t like the side effects."
"You can drive as long as you feel okay."
41
A nurse is caring for a patient on diazepam for muscle spasms. The nurse should advise the patient to avoid?
Alcohol
Vitamin D
Fruit juices
Caffeine
42
A patient is in the emergency department with status epilepticus, what drug of choice (all that apply)
Diazepam
Gabapentin
Midazolam
Levetiracetam
43
Which statement is true concerning lithium?
The maximum dose is 3.4 g/day.
The therapeutic drug range is 2.5 to 3.5 mEq/L.
Lithium increases receptor sensitivity to gamma-aminobutyric acid.
Concurrent nonsteroidal drugs (NSAIDs) may increase lithium levels.
44
A nurse is teaching a patient about ibuprofen for pain relief. Which of the following indicates further teaching?
"Ibuprofen can be used to relieve my pain and inflammation."
"I should not take ibuprofen for longer than recommended by my HCP."
"I should take ibuprofen with food to avoid an upset stomach."
"If I miss a dose, I should take two doses to make up for the missed one."
45
A nurse is reviewing the medication orders for a patient on
duloxetine
. Which of the following is a contraindication ?
History of peptic ulcer disease
Concurrent use of a monoamine oxidase inhibitor (MAOI)
Hypertension
History of seizures
46
A nurse is teaching a patient on morphine for pain relief. Which of the following should the nurse include?
"Do not drive or operate heavy machinery while taking this medication."
"It’s okay to take morphine with alcohol, but do so in moderation."
"You should take morphine on an empty stomach for best absorption."
"You may take an extra dose if you feel the medication is not working."
47
Antipsychotic medication and exhibiting acute muscle spasms, and stiffness. Which of the following interventions should?
Encourage the client to perform deep breathing exercises
Administer an anticholinergic medication such as benztropine
Prepare for electroconvulsive therapy (ECT)
Increase the dose of the antipsychotic medication
48
The nurse is aware that the rate of absorption can be changed by which actions? (Select all that apply.)
Forming drug complexes
Eating too slowly
Modifying gastric emptying time
Decreasing inflammation
49
A nurse is caring for a patient on phenobarbital. Which of the following is a common side effect of phenobarbital ?
Diarrhea
Sedation
Hypotension
Hyperactivity
50
Lidocaine hydrochloride is for general anesthesia
True
False
51
About the use of benzodiazepines, which statement by the patient indicates a need for further education?
"I need to let my doctor know if I plan to stop taking this suddenly."
"I should avoid alcohol while taking this medication."
"I can take this medication for a long time without any issues."
"I might feel drowsy after taking this medication."
52
A nurse is caring for a patient on
fluoxetine
for depression. The nurse should be most concerned if patient reports.
"I have been feeling more energetic , but feel like I can't sit still."
"I am still having difficulty sleeping, but I am not as sad."
"I have thoughts that life isn’t worth living anymore."
"I feel like I can finally think more clearly."
53
A patient is having a migraine attack. The nurse should know which drugs are used to treat migraine attacks.
Triptans
Tricyclic antidepressants
Beta-adrenergic blockers
Anticonvulsants
54
A nurse gives lorazepam to a patient with generalized anxiety disorder. The nurse knows that lorazepam works by which?
Increasing dopamine release in the brain
Inhibiting the reuptake of serotonin
Blocking norepinephrine receptors
Enhancing the effects of gamma-aminobutyric acid (GABA)
55
The nurse teaches the patient that the dosage should not exceed which amount for acetaminophen?
1Gram /day
4Gram/day
6Garm/day
3Gram/day
56
Several children are admitted with ADHD , a nurse what to watch for ?
A girl who lacks impulsivity
A boy with an inability to complete tasks
A boy with smooth coordination
A lethargic girl
57
I do not know why I am taking all of these pills.” Based on this subjective data, which problem will the nurse identify?
Pain
Anxiety
Fatigue
Knowledge
58
The nurse knows which drug is a selective serotonin reuptake inhibitor?
Divalproex sodium
Paroxetine
Bupropion hydrochloride
Amitriptyline
59
The nurse is monitoring a patient who is on phentermine. Which is important to observe? (Select all that apply.)
Bradycardia
Hypotension
Insomnia
Palpitations
Dry mouth
Euphoria
60
The nurse is teaching a patient about taking aspirin. Which are important points to include? (Select all that apply.)
Suggest that aspirin may be given to children for flu symptoms.
Instruct the patient to take aspirin before meals on an empty stomach.
Instruct the patient to inform the dentist of aspirin before dental work.
Advise the patient to avoid alcohol while taking aspirin.
Instruct the patient to inform the surgeon before having surgery.
Advise that urine may be a harmless pinkish-red or reddish-brown color.
61
Which of the following instructions should the nurse include in the teaching for a patient on midazolam?
"You can stop the prescribed pain medication immediately."
"Avoid alcohol and other sedatives for at least 24 hours."
"You can drive and operate heavy machinery after 4 hours."
"You may resume normal activities after 1 hour."
62
A nurse is assessing a patient who is taking phenytoin. Which of the following is a common side effect of phenytoin?
Constipation
Gingival hyperplasia
Hyperkalemia
Weight loss
63
A patient asks the nurse about drug interactions with over-the-counter preparations. Which is the nurse’s best response?
There are not many interactions, so don’t worry about it.
Avoid over-the-counter preparations
Discuss this with the health care provider.
Read the labels carefully, and check with your health care provider.
64
A nurse is caring for a client prescribed valproic acid (Depakote). Which of the following lab test should be monitored
Serum potassium levels
Complete blood count (CBC)
Renal function tests
Liver function tests
65
Which of the following statements by a patient indicates the need for further teaching about naloxone (Narcan)?
"I should call 911 if I administer naloxone to someone who has overdosed."
"It can reverse the effects of opioid overdose restore normal breathing."
"I need to stay with the person after to make sure don’t go back overdose
"Naloxone can be used as a long-term treatment for opioid addiction."
66
A client receiving haloperidol (Haldol) develops (NMS)—the provider orders dantrolene (Dantrium). It is for?
Reduce fever and muscle rigidity
Improve the absorption of haloperidol
Stimulate dopamine receptors in the brain
Treat the underlying psychiatric condition
67
A nurse is caring for a patient who is on duloxetine for generalized anxiety disorder. Should the nurse monitor for?
Bradycardia
Weight loss
Hypertension
Hyperkalemia
68
With an antidepressant patient, what does the nurse do? (Select all that apply.)
Monitor the patient for suicidal tendencies.
Teach the patient to take the drug with food if gastrointestinal distress
none
Advise the patient to maintain adequate fluid intake of 2 L/day.
Tell the patient that the drug may not be effective for 1 to 2 weeks.
Observe the patient for orthostatic hypotension.
69
ADHERENCE for drug regimens for older adults are trouble some
False
True
70
Which is important for the nurse to include in the teaching of zolpidem?
It is used for short-term treatment less than 10 days.
The drug may cause excitation.
The drug should only be used for 21 days or less.
For older adults, the dose is 15 mg at bedtime.
The drug may cause increased salivation.
The maximum dose is 20 mg/day.
71
A nurse is caring for a patient who is on sumatriptan for the treatment of migraines. The nurse should monitor for ?
Hypotension
Hyperglycemia
Tachycardia
Bradycardia
72
A nurse is reviewing the history of a patient prescribed
trazodone
. Which of the following is a
contraindication
?
History of seizures
Recent myocardial infarction
Heart failure
History of stroke
73
Which factors contribute to polypharmacy in older adults? (Select all that apply
Care coordination by a nurse
Use of a single pharmacy
Multiple chronic diseases
Multiple health care providers
74
After intravenous morphine administration, the nurse notes cold, clammy skin a respirations 10, what should be given?
Propoxyphene
Naloxone
Meloxicam
Pentazocine
75
Which teaching point is most important for a patient taking a selective serotonin reuptake inhibitor (SSRI) for anxiety?
This medication will take effect immediately.
Take the medication only as needed.
You can stop the medication if you feel better.
Report any thoughts of self-harm to your healthcare provider.
76
A patient is on amitriptyline for depression and is switched to a different antidepressant. Should the nurse teach?
Decreased appetite
Hypertensive crisis
Excessive sedation
Increased risk of suicide
77
Which nursing intervention is of “most importance” to ensure the patient’s safety?
Crush and mix the medications into the patient’s meal.
Administer unpleasant tasting drugs with a glass of water.
Administer drugs on a full stomach to avoid gastrointestinal (GI) upset.
Perform an assessment on the patient for risk of aspiration
78
The nurse knows which medication will cause the least gastrointestinal distress.
Ibuprofen
Celecoxib
Aspirin
Ketorolac
79
Which needle and gauge are most appropriate for intradermal injection?
⅝- to 1½-inch needle, 18- to 25-gauge
1- to 1½-inch needle, 20- to 21-gauge
¼- to ½-inch needle, tuberculin syringe
¾- to ⅝-inch needle, 25- to 27-gauge
80
Phenytoin has been prescribed for a patient with seizures, what is phenytoin therapeutic level?
5-10mcg/ML
no therapeutic level is needed
10-20mcg/ML
5-45mcg/ML
81
A nurse is providing discharge teaching to a patient on phenytoin. Which of the following instruction is most important?
"You need to have blood levels of phenytoin checked regularly."
"You should take phenytoin with milk to reduce gastrointestinal upset."
"You should avoid foods high in vitamin K."
"You can stop taking phenytoin once you feel better."
82
A nurse is teaching a patient on zolpidem. Which of the following statements needs further teaching?
"I can take it if I wake up in the middle of the night with difficulty
"I should not take more than the prescribed dose, even if I am still awake
"I should avoid drinking alcohol while taking this medication."
"I should avoid driving the day after taking this medication."
83
Which of the following is an important consideration regarding pregnancy and valproic acid use?
Valproic acid is safe to use during pregnancy.
Valproic acid should be stopped immediately if the patient is pregnant.
Valproic acid does not affect pregnancy, no special precautions are needed.
Valproic acid is a teratogenic and so adequate contraception is needed
84
The Quality and Safety Education for Nurses’ focus on safety is best exemplified by which competency?
Patient advocacy
Infection control
Collaborative patient and family care
Technology