RN is teaching pharmacology class to student RNs. What does the RN include as key events in the history of pharmacology?

Early researchers used themselves as test subjects.

RN is teaching pt who is taking allopurinol about minimizing AE. Which of the following instructions should RN include?

eat a small meal before taking the drug

A pt admitted w/hep B is prescribed hydrocodone w/acetaminophen (Vicodin),2 tabs,for pain. What is the most appropriate?

Recheck the order with the healthcare provider

Pt requires drug that is known to be completely metabolized by 1st-pass effect.What change is needed when drug is given?

The drug must be given by a non-oral route, such as parentally.

Elderly pt has GI bleeding. PT says All I do is take Advil for my arthritis. Nurse education to the client?

A plan to teach the advantages and disadvantages of ibuprofen (Advil)

What administration considerations apply to naloxone?

Monitor vital signs., Prepare to administer every 2-3 min until reversal of undesirable effects., Titrate doses carefully., Administer IM, IV, or SC.

A patient with cirrhosis of the liver has hepatic impairment. This will require what possible changes?

A reduction in the dosage of the drugs, A change in the timing of medication administration, More frequent monitoring for adverse drug effects

What is the rationale for the administration of a loading dose of a drug?

It more rapidly builds plasma drug levels to a plateau level.

RN reads that drug to be given to pt has a"narrow therapeutic index"RN knows that this means the drug properties are?

Has a narrow safety margin & even small increase in dose may produce toxic

RN administers Vx to a child. What is the best understanding of the RN as it relates to the manufacture of this vaccine?

The vaccine is naturally produced in animal cells or microorganisms.

RN is caring for pt who is taking acetaminophen for mild discomfort. Pt should report which early toxicity sign?

nausea and diarrhea, diaphoresis

RN is caring for postoperative pts. RN should identify that morphine is contraindicated for which of the following pts?

client who had a cholecystectomy

RN is caring for a pt who is taking naloxone to treat acute morphine toxicity. Drug reactions RN should watch for?

ventricular arrhythmias, increased pain, increased respiratory rate

RN has several pts on opioids for pain. Which pt is @ risk of developing hypotension, decreased RR, mental confusion?

An 86-year-old male, postoperative femur fracture

RN is employed by FDA and is involved in clinical investigation. What is the primary role of RN in this phase of review?

To perform tests on human clients

Pt is admitted to the hospital in chronic renal failure and on several meds.What best describes RN's assessment of pt?

Pt may have drug toxicity from all the drugs.

RN is teaching pt who has a new Px for prednisone. Which of the following instructions should the nurse include?

report illness or infection, discontinue the drug gradually, monitor for signs of gastric bleeding, increase intake of calcium and vitamin D

64yr old pt w/diabetes is on prednisone for RA.Pt recently admitted for stabilization of hyperglycemia.Primary concern?

Hypertension/ Fluid retention, Risk for infection, Hyperglycemia

Which reference book is recognized by the United States government as the official list of drug standards?

United States Pharmacopeia/National Formulary (USP/NF)

Side effects for naloxen. Select all that apply

Cardiac arrest, Seizures, Pulmonary edema, Hypotension

What administration considerations apply to acetaminophen?

Infants/children should be given the manufacturer’s dose based on their age, Caution pts that the drug is available in many combination products, Administer orally or rectally., Do not administer more than 4 g/day (adults).

Which statements regarding the role of the U.S. Food and Drug Administration (FDA) are true?

The FDA ensures the availability of effective drugs., The FDA takes action against any supplement that is deemed to be unsafe., The FDA is responsible for ensuring the security of human drugs., The FDA facilitates the availability of safe drugs.

Pt who has acute kidney injury may have diminished capacity to excrete meds. RN must assess pt more frequently for what?

Increased risk for drug toxicity

Should a patient with peptic ulcers or bleeding disorders take NSAIDs?

No, beacuse it can increase GI upset and bleeding

RN is teaching pt who has a new Px for tramadol. Which of the following instructions should the nurse include?

change positions gradually, increase fiber and fluid intake, take the drug with foodavoid driving after taking the drug

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Pharm Exam 1

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Questions 95

Answers

1
RN is caring for a pt who began taking aspirin. RN should instruct pt to report which manifestations of salicylism?
Diaphoresis
Fever
Tinnitus
Dizziness
2
RN is teaching pharmacology class to student RNs. What does the RN include as key events in the history of pharmacology?
The initial intention of pharmacology was to relieve human suffering.
Early researchers used themselves as test subjects.
Pharmacologist synthesized drugs in the laboratory in the twentieth century
Initial drugs included morphine, cocaine, and penicillin.
3
RN is teaching pt who is taking allopurinol about minimizing AE. Which of the following instructions should RN include?
avoid the use of NSAIDs
eat a small meal before taking the drug
suck on hard candy or chew gum
take a stool softener daily
4
A pt admitted w/hep B is prescribed hydrocodone w/acetaminophen (Vicodin),2 tabs,for pain. What is the most appropriate?
Administer 1 tablet only
Recheck the order with the healthcare provider
Administer the drug as ordered
Hold the drug until the healthcare provider arrives
5
RN is caring for a pt who currently takes furosemide and prednisone. RN should monitor which manifestations?
Hypercalcemia
Hypothermia
Hypokalemia
Hypoglycemia
6
Pt requires drug that is known to be completely metabolized by 1st-pass effect.What change is needed when drug is given?
The drug must be given in higher doses.
The drug must be given by a non-oral route, such as parentally.
The drug must be given more frequently.
The drug must be given in a lipid-soluble form.
7
Elderly pt has GI bleeding. PT says All I do is take Advil for my arthritis. Nurse education to the client?
A plan to teach the advantages and disadvantages of ibuprofen (Advil)
A plan to teach pt to substitute safer drugs like acetaminophen (Tylenol)
A plan to teach pt to use drugs that bypass GI system, like topical drugs
A plan to teach pt to obtain physician approval prior to use of OTC meds
8
Ketorolac is most commonly given in what route?
Oral
Transdermal
IV
IM
9
This is a cox inhibitor, inhibits platelet aggregation, max dose is 3.2 g/day, Pt should sit up w/ a full glass of water
Ibuprofen
Naproxen
Ketorolac
Aspirin
10
What administration considerations apply to naloxone?
Monitor vital signs.
Prepare to administer every 2-3 min until reversal of undesirable effects.
Titrate doses carefully.
Administer IM, IV, or SC.
11
A patient with cirrhosis of the liver has hepatic impairment. This will require what possible changes?
A reduction in the dosage of the drugs
A change in the timing of medication administration
More frequent monitoring for adverse drug effects
Giving all prescribed drugs by intramuscular injection
12
RN is caring for pt who is taking allopurinol for gout.RN should monitor pt for which hypersensitivity syndrome S&S?
Anxiety
Muscle Pain
Fever
Tremors
13
What is the rationale for the administration of a loading dose of a drug?
It results in lower dosages being required to achieve therapeutic effects.
It more rapidly builds plasma drug levels to a plateau level.
It decreases the number of doses that must be given
It decreases the risk of drug toxicity.
14
RN reads that drug to be given to pt has a"narrow therapeutic index"RN knows that this means the drug properties are?
Has a narrow range of conditions/diseases that drug will be successful
Has a narrow safety margin & even small increase in dose may produce toxic
Has narrow range of effectiveness & may not give pt therapeutic response
15
RN administers Vx to a child. What is the best understanding of the RN as it relates to the manufacture of this vaccine?
The vaccine is produced by a combination of animal and plant products.
The vaccine is produced by natural plant extracts in the laboratory.
The vaccine is naturally produced in animal cells or microorganisms.
The vaccine is most commonly synthesized in a laboratory.
16
Which of the following is an example of an NSAIDs? Select all that apply
Naloxen
Naproxen
Aspirin
Ibuprofen
17
RN is caring for pt who is taking acetaminophen for mild discomfort. Pt should report which early toxicity sign?
nausea and diarrhea
palpitations
diaphoresis
shortness of breath
18
Drug half-life is defined as the amount of time required for 50% of a drug to _______.
Reach a therapeutic level.
Be removed by the body.
Be absorbed by the body.
Exert a response.
19
RN is caring for postoperative pts. RN should identify that morphine is contraindicated for which of the following pts?
client who had a mastectomy
client who had a cholecystectomy
client who had a colectomy
client who had a knee arthroplasty
20
RN is caring for a pt who is taking naloxone to treat acute morphine toxicity. Drug reactions RN should watch for?
thromboplebitis
ventricular arrhythmias
increased pain
increased respiratory rate
21
Drug manufacturer that is performing effects of drug on lab animals, which phase of new drug development timeline?
Postmarketing Studies
New Drug Application Review
Clinical Investigation
Preclinical Investigation
22
RN is caring for pt who has Px for prednisone for long-term treatment of RA. RN should monitor which adverse reaction?
Breast Cancer
Bone Loss
Pulmonary Embolism
Hepatitis
23
RN has several pts on opioids for pain. Which pt is @ risk of developing hypotension, decreased RR, mental confusion?
An 86-year-old male, postoperative femur fracture
A 54-year-old female, post-myocardial infarction
A 16-year-old male, post-motorcycle crash injury with lacerations
A 23-year-old female, postoperative ruptured appendix
24
RN is employed by FDA and is involved in clinical investigation. What is the primary role of RN in this phase of review?
To perform tests on the population-at-large
To perform tests on human clients
To perform tests on human cells cultured in the laboratory
To perform tests on various species of animals
25
Pt is admitted to the hospital in chronic renal failure and on several meds.What best describes RN's assessment of pt?
Pt may have decreased effectiveness of the drugs.
Pt may have drug toxicity from all the drugs.
Pt's liver may compensate for renal failure; the drugs may be effective
Pt may have drug toxicity only if the drugs are excreted by the kidneys
26
Pt w/diabetes reports increasing pain &numbness in his legs"It feels like pins & needles, especially @ night.Prescribed?
Naloxone/Narcan
Gabapentin/Neurontin
Ibuprofen/Motrin
Methadone
27
RN is caring for pt who has a new Px for celecoxib. RN should tell pt to report which of the following adverse reaction?
Chest Pain
Constipation
Tinnitus
Diaphoresis
28
RN is teaching pt who has a new Px for prednisone. Which of the following instructions should the nurse include?
report illness or infection
discontinue the drug gradually
monitor for signs of gastric bleeding
increase intake of calcium and vitamin D
29
RN is caring for pt who has a new Px for butorphanol. RN should monitor pt for which of the following adverse reactions?
Headache
Nausea
Tachycardia
Dizziness
30
These are used for mild-moderate pain, fever, inflammation and mode of action is it inhibits prostanglandin synthesis.
Opioid- Antagonist
Opioid-Agonist
NSAIDs
Non-opioid- Analgesic
31
The application of drugs for the purpose of disease prevention and treatment of suffering is known as
pharmacotherapeutics
biologics
therapeutics
alternative therapies
32
Name this drug class: treats moderate-severe pain, promotion of sedation and has a risk for addiction
Opioid-Antagonist
Non-Opioid Analgesic
Opioids- Agonist
NSAIDs
33
64yr old pt w/diabetes is on prednisone for RA.Pt recently admitted for stabilization of hyperglycemia.Primary concern?
Hypertension/ Fluid retention
Risk for infection
Hyperglycemia
Urinary retention
34
What should you monitor when taking acetaminophen?
Input and oputput
Cardiac function
Renal function
Respiratory rate
35
The brand name for acetaminophen is Tylenol.
False
True
36
Which reference book is recognized by the United States government as the official list of drug standards?
United States Pharmacopeia/National Formulary (USP/NF)
Physician's Drug Reference (PDR)
United States Pharmocopeia Dispensing Information (USPDI)
Handbook of Nonprescription Drugs
37
Side effects for naloxen. Select all that apply
Cardiac arrest
Seizures
Pulmonary edema
Hypotension
38
What administration considerations apply to acetaminophen?
Infants/children should be given the manufacturer’s dose based on their age
Caution pts that the drug is available in many combination products
Administer orally or rectally.
Do not administer more than 4 g/day (adults).
39
RN is categorizing pt’s meds completing a health hx. Which would be categorized as complementary & alternative meds?
Vitamin C
Garlic
Zinc
Benadryl
40
Which statements regarding the role of the U.S. Food and Drug Administration (FDA) are true?
The FDA ensures the availability of effective drugs.
The FDA takes action against any supplement that is deemed to be unsafe.
The FDA is responsible for ensuring the security of human drugs.
The FDA facilitates the availability of safe drugs.
41
Pt who has acute kidney injury may have diminished capacity to excrete meds. RN must assess pt more frequently for what?
Increased risk for drug toxicity
Increased absorption of the drug from the intestines
Increased risk of allergy
Decreased therapeutic drug effects
42
24 yr old pt reports taking acetaminophen fairly regularly for headaches while drinking. RN should watch for what AE?
Thrombotic effects
Hepatotoxicity
Pulmonary damage
Renal damage
43
What term describes the desired or predicted physiological response of a drug?
side effect
systemic effect
adverse reaction
therapeutic effect
44
The passage of a drug from the site of administration into the bloodstream is called?
absorption
distribution
metabolism
excretion
45
Pt's blood shows low serum albumin level.She is receiving a med that is normally 95% protein bound.Monitor for what?
Drug toxicity
Hyperalbuminemia
Hypokalemia
CNS depression
46
Should a patient with peptic ulcers or bleeding disorders take NSAIDs?
Yes, it should cause any issues as long as they don't drink
Yes, it should be just fine
No, beacuse it can increase GI upset and bleeding
No, because theres a herbal remedy out there to solve it all
47
RN is caring for a pt who has a viral infection. RN should identify which drug can increase the risk of Reye syndrome?
Aspirin
Tramadol
Acetaminophen
Butorphanol
48
Pt w/chronic back pain informs RN he has been receiving therapeutic touch in addition to meds.Therapy is classified as?
biologic therapy
complementary therapy
pharmacotherapy
drug-absence therapy
49
RN is reviewing MR of a pt who reports taking acetaminophen @ home. Which as a contraindicted of acetaminophen?
Diabetes Mellitus
Alcohol Use Disorder
Asthma
Heart Failure
50
Combo of 2 diff antihypertensive drugs in lower doses has been ordered for a pt. Term?
Antagonism
Displacement
Synergism
Addition
51
RN is teaching pt who has a new Px for tramadol. Which of the following instructions should the nurse include?
change positions gradually
increase fiber and fluid intake
take the drug with foodavoid driving after taking the drug
reduce exercise level temporarily
52
What term describes the study of the absorption, distribution, metabolism and excretion of a drug?
pharmacology
physiology
pharmacokinetics
pharmacodynamics
53
Another term for brand name is?
generic name
nonproprietary name
chemical name
trade name
54
Which of the following are an example of opioid- agonist? Select all that apply
Naloxen
Fentanyl
Morphine (IV)
Acetaminophen
55
RN is planing care for a pt who has started taking prednisone. Which of the following interventions should RN include?
administer aspirin rather than NSAIDs if the client has pain
administer an antacid 30 min prior to prednisone
monitor the client for hyperkalemia
monitor the clients blood glucose
56
Which of the following is not a commonly abused drug?
insulin
alcohol
steroids
nicotine
57
Which of the following are side effects of NSAIDs?
GI upset/ bleeding
Headache
Renal Toxicity
Rash
58
RN is reviewing MR of a pt who has a new px for celecoxib.RN should identify which is a contraindication to celecoxib?
sulfonamide allergy
rheumatoid arthritis
adrenocortical
insufficiency
59
What are the manifestations of hepatotoxicity the nurse should monitor for? (Select All that Apply)
Jaundice
Elevated AST and ALT
Increased creatinine greater than 1.4
Signs of bleeding
60
What administration considerations apply to celecoxib?
Monitor for initial and continued therapeutic effects.
Have patient continue taking at full dose when developing gastric ulcers
Ignore stomach pain, headache, diarrhea when taking it because its fine
Give 2 hr before or after magnesium- or aluminum-based antacids.
61
Modern pharm was introduced to the US by the opening of the first department of pharm at the University of Michigan
1890
1847
1805
1908
62
What administration considerations apply to morphine?
Administer IV opioids slowly and with recommended dilution over 4 to 5 min
Administer orally, IM, IV, SC, rectally, or epidurally.
Measure baseline vitals before administration & monitor throughout therapy.
Make sure pts swallow sustained-release forms whole & do not crush or chew
63
Pt is taking aspirin for several days for headache.RN finds that pt has ringing in the ears & dizziness. Nurse action?
Tell the patient to take the aspirin with food or milk
Question the patient about history of sinus infections
Tell the patient not to take any more aspirin
Determine whether the patient has mixed the aspirin with other medications
64
RN is reviewing the MR of a pt who has a new Px for tramadol. RN should identify that which is a contraindication?
rheumatoid arthritis
seizure disorder
urinary incontinence
hyperthyroidism
65
Which of the following are nursing interventions when giving opioid-agonists?
Watch intake and output
Increase Fluids
Watch vital signs especially RR status
Increase Fiber
66
How many years does it generally take to research and develop a drug before it is submitted to the FDA for review?
5 years
9 years
11 years
6 years
67
An unexpected finding while taking aspirin is what?
Tinnitus
Diarrhea
Gas production
Bleeding
68
RN is caring for pt who asks about acetaminophen.RN should identify that acetaminophen is indicated for which condition?
To reduce fever
To relieve mild pain
To decrease inflammation
To promote sedation
69
RN is teaching a pt who has a new px for allopurinol. Which of the following instructions should the RN include?
limit fluid intake during therapy
avoid crushing the tablets
avoid driving or activities that require mental alertness
limit potassium while taking allipurinol
70
What are the therapeutic uses for celecoxib? Select all that apply
Dysmenorrhea
Fever reduction
Inflammation suppression
Analgesia for mild to moderate pain
71
Which teaching is needed for pt who is to be discharge post op w/a Px for oxycodone w/acetaminophen should be included?
Refer the patient to a drug treatment center if addiction occurs.
Monitor for gastrointestinal bleeding.
Teach the patient to self-assess blood pressure.
Encourage increased fluids and fiber in the diet.
72
What percentage of Americans takes at least one prescription drug per year?
25%
50%
40%
10%
73
RN is caring for pt who takes low dose aspirin to prevent cardiac events.Pt asks to take Ibu for RA.What should RN say?
"ibuprofen will increase your risk for developing salicylism"
"low-dose aspirin will reduce the anti-inflammatory effects of ibuprofen"
"ibuprofen will reduce the cardioprotective effects of low-dose aspirin"
"low-dose aspirin will reduce the analgesic efforts of ibuprofen"
74
RN instructor is teaching pharm class to student RN.Focus of pharm & therapeutics.Learning has occured by which comment?
"Pharmacology is the study of drugs to prevent disease."
"Therapeutics is the study of the therapeutic use of drugs."
"Pharmacology is the use of drugs to relieve suffering."
"Pharmacology is the study of medicines."
75
What precautions do we watch out for when giving acetaminophen to a patient?
Anemia
Asthma
Immunosuppression
Hepatic or kidney disease
76
RN is reviewing drug list for pt who has a new px for allopurinol. RN should identify which drug reacts w/ allopurinol?
Ibuprofen
Furosemide
Warfarin
Insulin
77
The passage of a drug from the bloodstream to the body tissues and intended site of action is called?
excretion
distribution
absorption
metabolism
78
Side effects of opioid-agonist. Select all that apply
GI upset
Urinary retention
Constipation
Respiratory depression
79
This medication can cause Kawaskaii's disease it also puts pt at high risk for bleeding, inhibits prostanglan.
Aspirin
Ibuprofen
Naproxen
Ketorolac
80
RN is caring for a pt who is receivng morphine for severe pain. RN should monitor the pt for which adverse reaction?
Diarrhea
Orthostatic Hypotension
Urinary Retention
Respiratory Depression
81
RN is reviewing a pt's health record & notes the provider has requested to verify the trough level of the pt's med. Do?
Have a blood specimen obtained 30 mins prior to the next dose of med
Verify the pt has been on the med for 24 hr before ordering blood specimen.
Ask the pt to provide a urine specimen after the net dose of medication.
Begin administering the medication, and then obtain a specimen.
82
Which of the following patients should you be cautious with when giving them acetaminophen?
Chronic malnutrition
Severe renal impairment
Severe hypervalemia
Alcoholism
83
Student RN asks RN instructor why he needs to take A & P and micro, when he only wants to learn about pharm. Response?
Knowledge of all those subjects will prepare you to provide best pt care
"Because pharmacology is an outgrowth of those subjects."
Because understanding of those subjects is essential to understanding pharm
You learn all, those subjects, as well as pharm, are part of the curriculum
84
What precautions do we watch out for when giving aspiren and ibuprofen to a patient?
Heart failure
Cigarette smoking
Older adults
Alcohol use disorder
85
RN is caring for pt who has a px for aspirin to treat ankle pain. Pt should report which adverse drug reaction?
Infection
Polyuria
Bone Pain
Weight Gain
86
16yr pt is 6 wks pregnant.It has exacerbated her acne.Pt asks RN if she can take isotretinoin px, category X.Response?
You should check with your healthcare provider at your next visit
Since you have a prescription for isotretinoin, its safe to resume using it
Isotretinoin is known to cause birth defects & never be taken pregnant
You should reduce the isotretinoin dosage by half during pregnancy
87
Which of the following would require further teaching for a nurse if done?
Nurse educates client on the risk for addiction with opioid-agonists
Nurse increases fluids and fiber intake when giving opioid-agonists
Nurse gives patient opioid- agonist for their severe pain as the Dr. order
Nurse instructs pt to stop opioid-agonist abruptly when they don't need it
88
What are common side effects of aspirin?
GI Bleeding
Tinnitus
Reye's syndrome
Peptic Ulcer disease
89
T or F: A patient overdosing from opioids may need several doses of naloxen.
True
False
90
Pt has both live/kidney disease. Pt takes several enteral meds. You would expect duration of action of these meds to...
Decrease
Stay the same
Increase
Be absent
91
RN is teaching pt who has a new px for allopurinol. RN should instruct pt to report which adverse reaction?
Vertigo
Palpitations
Sore Throat
Vision Changes
92
RN is caring for a pt who is opioid dependent and has a new Px for butorphanol. Abstinence syndorme manifestation?
Vomiting
Hypertension
Bronchospasm
Abdominal Cramps
93
RN is talks to mom regarding antipyretic choices for her 8yr-old.When asked why aspirin is not a good drug,RN statement?
It increases the risk of Reye's syndrome in children under 19 w/infection
It may increase fever in children under age 10
It may produce nausea vomiting
Is not as good an antipyretic as is acetaminophen
94
What administration considerations apply to aspiren and ibuprofen?
Monitor for initial and continued therapeutic effects.
Discontinue 1 week before scheduled surgery.
Allow pt to crush or chew medication because it can be dissolved quicker
Make sure pts swallow enteric-coated forms whole and do not crush or chew
95
Which of the following are signs of opioid withdrawal?
Anoerxia
Decreased LOC
Abdominal cramps
Back Ache

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