Download PHARMACOLOGY TEST BANK 2 QUESTION AND ANSWERS 2024 LATEST REVISED GRADED A+. and more Exams Nursing in PDF only on Docsity!
PHARMACOLOGY TEST BANK 2
QUESTION AND ANSWERS 2024 LATEST
REVISED GRADED A+.
A nurse is ordered to draw blood levels for a person receiving an antibiotic. The nurse is aware that peaks and troughs of serum antibiotic levels are monitored for drugs with a: - Precise answer narrow therapeutic index. A client's medication warrants peak and trough levels to be drawn. The nurse is aware that if the peak level of the drug is too high, what could occur? - Precise answer Drug toxicity Drug concentration is important for the eradication of bacterial infection. It is desired to keep the drug dose: - Precise answer Above minimum effective concentration With continuous use of antibiotics, antibiotic resistance result because: - Precise answer mutant bacteria are surviving antibiotic use client with otitis media is ordered to receive amoxicillin (Amoxil). The client discloses to the nurse that she is allergic to penicillin. What is the highest priority action on the part of the nurse? - Precise answer Notify healthcare A client has relayed instructions from a physician regarding an allergy to a type of antibiotic therapy. The nurse would question which instruction - Precise answer Restrict fluids when taking the antibiotic When antibacterials are prescribed for the treatment of an infection and a culture is ordered, what should happen next? - Precise answer culture should be taken before the initial dose of the antibiotic A client at an outpatient clinic is ordered to receive ampicillin (Omnipen) for an infection. Which nursing intervention related to penicillins would the nurse question? - Precise answer Instruct client to discontinue penicillin when temperature is normal.
Most beta-lactam antibiotics are excreted through the kidneys. The nurse should assess the client's renal function by monitoring which levels? - Precise answer Blood urea nitrogen and serum creatinine A client is ordered to receive a cephalosporin to treat a bacterial infection. Regarding monitoring of the client, the highest priority action on the part of the nurse includes assessing the client for which side effects? - Precise answer Nausea, vomiting and diarrhea A client has been receiving a cephalosporin for 20 days to treat a severe bacterial infection. The client complains of mouth pain, and the nurse assesses white patches in the client's mouth. What is the highest priority action on the part of the nurse? - Precise answer Notify the physician and describe symptoms A client who reports an allergy to penicillin is ordered to receive cephalexin (Keflex). The correct action for the nurse is to: - Precise answer administer the medication and carefully observe for allergic reaction. The client has been ordered treatment with Cefaclor as well as erythromycin. The nurse anticipates what effect from the interaction of the medications? - Precise answer Decreased action of Cefaclor The client has been ordered Cefazolin. The nurse anticipates an increase in the client's _____ from this medication? - Precise answer BUN and serum creatinine The client has been ordered to be treated with amoxicillin. The highest priority instruction that the nurse should give the client related to diet while on the medication is to avoid: - Precise answer Acidic fruits and juices The client has been ordered treatment with Wycillin. The nurse notes that the solution is milky in color. What is the highest priority action on the part of the nurse? - Precise answer Administer the medication as ordered by the physician The client has been ordered treatment with Amoxil. The client reports to the nurse that she has developed symptoms of vaginitis. The highest priority action on the part of the nurse is to recognize this as: - Precise answer Evidence of development of a superinfection
indane (Kwell, Scabene) is used to treat several different disorders. For which disorder is the use of lindane (Kwell, Scabene) contraindicated? - Precise answer Seizures Scabies treatment for a 4-year-old child includes a prescription for: - Precise answer Permethrin 5% applied from the neck down Vanessa has been diagnosed with scabies. Her education would include: - Precise answer All member of the household and close personal contacts should be treated Catherine has head lice and her mother is asking about what products are available that are not neurotoxic. The only non-neurotoxin head lice treatment is: - Precise answer Benzoyl alcohol (Ulesfia) A nurse is caring for a patient who is on amphotericin B. On morning rounds the patient reports weakness, numbness, and a tingling sensation in his feet. What would be a priority action by the nurse? - Precise answer Keep the bed in a low position and the side rails up at all times. A nurse is monitoring the fluid input and output of a 26-year-old woman who is on amphotericin B. Which of the following would the nurse report immediately to the physician? - Precise answer Serum creatinine level of 3.5 mg/dL The nurse is assessing a patient who is about to receive antifungal drug therapy. Which condition, if found in the patient, would be of most concern?
- Precise answer Liver diseases The nurse is preparing an infusion of amphotericin B for a patient who has a severe fungal infection. Which intervention is appropriate regarding the potential adverse effects of amphotericin B? - Precise answer Before beginning the infusion, administering an antipyretic and an antiemetic drug The nurse is administering one of the lipid formulations of amphotericin B. When giving this drug, which concept is important to remember? - Precise answer The lipid formulations are associated with fewer adverse effects than the older drugs.
A patient is infected by invasive aspergillosis, and the medical history reveals that the patient has not been able to tolerate several antifungal drugs. The nurse anticipates an order for which medication to treat this infection? - Precise answer caspofungin (Cancidas) During therapy with amphotericin B, the nurse will monitor the patient for known adverse effects that would be reflected by which laboratory result? - Precise answer Serum potassium level of 2.7 mEq/L A patient has received a prescription for a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, saying, "I don't want to do this for 2 weeks!" Which is a possibility in this situation? - Precise answer A single dose of a fluconazole (Diflucan) oral tablet Dwayne has classic tinea capitis. Treatment for tinea on the scalp is: - Precise answer Oral griseofulvin for a 6-8 weeks Nicolas is a football player who presents to clinic with athlete's foot. Patients with tinea pedis may be treated with: - Precise answer OTC miconazole cream for 4 weeks Jim presents with fungal infection of two of his toenails (onychomycosis). Treatment for fungal infections of the nail includes: - Precise answer Oral griseofulvin A patient who is diagnosed with shingles is taking topical acyclovir, and the nurse is providing instructions about adverse effects. The nurse will discuss which adverse effects of topical acyclovir therapy? - Precise answer Transient burning when applied The nurse is administering intravenous acyclovir (Zovirax) to a patient with a viral infection. Which administration technique is correct? - Precise answer Infuse intravenous acyclovir slowly, over at least 1 hour. A patient is receiving cidofovir (Vistide) as part of treatment for a viral infection, and the nurse is preparing to administer probenecid, which is also ordered. Which is the rationale for administering probenecid along with the cidofovir treatment? - Precise answer Concurrent drug therapy with probenecid reduces the nephrotoxicity of the cidofovir.
During drug therapy with a tetracycline antibiotic, a patient complains of some nausea and decreased appetite. Which statement is the nurse's best advice to the patient? - Precise answer "Drink a full glass of water with each dose." The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101° F (38.3° C). Based on these findings, which conclusion will the nurse draw? - Precise answer The patient needs to be tested for Clostridium difficile infection. The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy? - Precise answer Decreased white blood cell count The nurse is reviewing the sputum culture results of a patient with pneumonia and notes that the patient has a gram-positive infection. Which generation of cephalosporin is most appropriate for this type of infection? - Precise answer First-generation A patient will be having oral surgery and has received an antibiotic to take for 1 week before the surgery. The nurse knows that this is an example of which type of therapy? - Precise answer Prophylactic During drug therapy for pneumonia, a female patient develops a vaginal superinfection. The nurse explains that this infection is caused by - Precise answer large doses of antibiotics that kill normal flora. The nurse is preparing to use an antiseptic. Which statement is correct regarding how antiseptics differ from disinfectants? - Precise answer Disinfectants are used only on nonliving objects to destroy organisms. A patient with a long-term intravenous catheter is going home. The nurse knows that if he is allergic to seafood, which antiseptic agent is contraindicated? - Precise answer povidone-iodine (Betadine) During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment
findings may be an indication of a hypersensitivity reaction? (Select all that apply.) - Precise answer Wheezing Shortness of breath Swelling of the tongue itching The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.) - Precise answer Oral contraceptives Sulfonylureas phenytoin (dilantin) Warfarin (coumadin) patient will be receiving amoxicillin suspension 300 mg via a gastrostomy tube every 8 hours. The medication comes in a bottle that contains 400 mg/5 mL. How many milliliters will the nurse administer with each dose? (Record answer using one decimal place.) - Precise answer 3.8 mL 400 mg : 5 mL :: 300 mg : x mL Solve for x: (400 × x) = (5 × 300); 400x = 1500; x = 3.75, rounding to 3.8; administer 3.8 mL A patient will be receiving penicillin G potassium, 12 million units daily in divided doses every 4 hours IVPB. How many units will the patient receive for each dose? - Precise answer 2 million units If a medication is given every 4 hours, then there will be 6 doses in 24 hours (24 ÷ 4 = 6). 12 million units ÷ 6 doses = 2 million units/dose Appropriate initial treatment for psoriasis would be: - Precise answer Intermittent therapy with intermediate potency topical corticosteroids Patient education when prescribing the Vitamin D3 derivative calcipotriene for psoriasis includes - Precise answer A maximum of 100 grams per week may be applied Whart is the peak onset age of Psoriasis - Precise answer 16- 57-
Twenty-year-old Annie comes to clinic complaining of copious yellow-green eye discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While awaiting the culture results, the plan of care should be:
- Precise answer IM ceftriaxone Education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes: - Precise answer Throwing away eye makeup and purchasing new Sadie was prescribed betaxolol ophthalmic drops by her ophthalmologist to treat her glaucoma. Oral beta blockers should be avoided in patients who use ophthalmic beta blockers due to: - Precise answer The additive effects may include bradycardia David presents to clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eye drops. The education regarding using cromolyn eye drops includes: - Precise answer He should not wear his soft contacts while using the cromolyn eye drops Choose the type of ophthalmic medication that can result in glaucoma, cataracts, or secondary infection. - Precise answer Steroids Prescription of timolol maleate can result in several serious adverse reactions. Select the condition that is considered to be a common side effect of treatment with timolol maleate. - Precise answer Blurred vision Which situation shows appropriate use of an ophthalmic anesthetic for a patient with eye pain? - Precise answer Facilitation of examination of the eye The patient is suffering from glaucoma and is scheduled to begin treatment with carbachol (Carboptic). The health care provider knows to monitor the patient closely for evidence of which effect of the drug? - Precise answer Increased outflow of aqueous humor The patient is being treated with the drug pilocarpine (Pilocar). He complains of eye irritation. The most appropriate response of the health care provider is: - Precise answer This is an expected adverse reaction to the medication.
As the patient continues to undergo treatment with pilocarpine (Pilocar), he begins to experience itching of the eye. The most appropriate response of the health care provider is: - Precise answer This is an expected adverse reaction to the medication, and treatment to relieve this symptom will be initiated. patient with an eye injury requires an ocular examination to detect the presence of a foreign body. Which drug would a health care provider expect to be of most use in this examination? - Precise answer Fluorocaine Which drug would a health care provider recommend to a patient who complains of dry eyes? - Precise answer Polyvinyl alcohol (Hypotears) Caleb is an adult with an upper respiratory infection (URI). Treatment for his URI would include: - Precise answer Topical oxymetazoline Rose is a 3 year old with an upper respiratory infection (URI). Treatment for her URI would include: - Precise answer Nasal saline spray Patients who should be cautious about using decongestants for an upper respiratory infection include: - Precise answer Patients with cardiac disease Jaheem is a 10 year old with sinusitis. Treatment for a child with sinusitis - Precise answer Amoxicillin Jacob has been diagnosed with sinusitis. He is the parent of a child in daycare. Treatment for sinusitis in an adult who has a child in daycare is: - Precise answer Amoxicillin 1 gram QID The length of treatment for sinusitis should be: - Precise answer 7 days beyond when symptoms cease Patient education for a patient who is prescribed antibiotics for sinusitis includes: - Precise answer Use of nasal saline washes
Which of the following disease processes could be made worse by taking a nonselective beta blocker? - Precise answer both might worsen Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include: - Precise answer MI ACE inhibitors treat hypertension because they: - Precise answer Reduce sodium and water retention Decrease vasoconstriction Increase vasodilation Compelling indications for an ACE inhibitor as treatment for hypertension based on clinical trials includes: - Precise answer Renal parenchymal disease An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone? - Precise answer Nondihydropyridine calcium channel blockers If not chosen as the first drug in hypertension treatment, which drug class should be added as second step because it will enhance the effects of most other agents? - Precise answer Diuretics Treatment costs are important for patients with hypertension. Which of the following statements about cost is NOT true? - Precise answer Few antihypertensive drugs come in generic formulations. Caffeine, exercise, and smoking should be avoided for at least how long before blood pressure measurement? - Precise answer 30 minutes Blood pressure checks in children: - Precise answer Should be done during every health-care visit after age 3 Lack of adherence to blood pressure management is very common. Reasons for this lack of adherence include: - Precise answer Lifestyle changes are difficult to achieve and maintain
Adverse drug reactions are common and often fall into the categories more associated with nonadherence Costs of drugs and monitoring with labs can be expensive Lifestyle modifications for patients with prehypertension or hypertension include: - Precise answer Adopt the DASH diet The overall goal of treating hyperlipidemia is: - Precise answer To reduce atherogenesis When considering which cholesterol-lowering drug to prescribe which factor determines the type and intensity of treatment? - Precise answer Coronary artery disease risk level First-line therapy for hyperlipidemia is: - Precise answer Lifestyle changes James is a 45 year old with an LDL level of 120 and normal triglycerides. Appropriate first- line therapy for James may include diet counseling, increased physical activity, and: - Precise answer Sterols Joanne is a 60 year old with an LDL of 132 and a family history of coronary artery disease. She has already tried diet changes (increased fiber and plant sterols) to lower her LDL and after 6 months her LDL is slightly higher. The next step in her treatment would be: - Precise answer A statin Sharlene is a 65 year old who has been on a lipid-lowering diet and using plant sterol margarine daily for the past 3 months. Her LDL is 135 mg/dL. An appropriate treatment for her would be: - Precise answer Determined by her risk factors Mike is a 47 year old who has been on standard dose atorvastatin for 3 months and his repeat LDL is 124 mg/dL. He is a smoker and has a strong family history of cardiovascular disease. His treatment plan would include reinforcing diet, exercise, plant sterol intake, and: - Precise answer Increasing his dose of atorvastatin Phil is a 54-year-old male with multiple risk factors who has been on a high dose statin for 3 months to treat his high LDL level. His LDL is 135 mg/dL
Medication is a supplement to diet therapy and exercise If they have any muscle aches or pain, they should contact their provider Angina is produced by an imbalance between oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the following drugs help to correct this imbalance by increasing MOS? - Precise answer ACE inhibitors Not all chest pain is caused by myocardial ischemia. Non-cardiac causes of chest pain include: - Precise answer Pulmonary embolism Pneumonia Gastroesophageal reflux The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is: - Precise answer Class II Patients at high risk for developing significant coronary heart disease are those with: - Precise answer Class II angina To reduce mortality, all patients with angina, regardless of Class, should be on: - Precise answer Aspirin 81 to 325 mg/d Patients who have angina, regardless of Class, who are also diabetic, should be on: - Precise answer ACE inhibitors Management of all types and grades of angina includes the use of lifestyle modification to reduce risk factors. Which of these modifications are appropriate for which reason? Both the modification and the reason for it must be true for the answer to be correct. - Precise answer Reduce sodium intake to no more than 2,400 mg of sodium. Sodium increases blood volume and cardiac workload. Nitrates are especially helpful for patients with angina who also have: - Precise answer Heart Failure
Hypertension Beta blockers are especially helpful for patients with exertional angina who also have: - Precise answer Arrythmias Rapid-acting nitrates are important for all angina patients. Which of the following are true statements about their use? - Precise answer Take one nitroglycerine tablet or spray at the first sign of angina; repeat every 5 minutes for no more than three doses. If chest pain is still not relieved, go to the hospital. Isosorbide dinitrate is a long-acting nitrate given BID. The schedule for administration is 7 AM and 2 PM because: - Precise answer Nitrate tolerance can develop Combinations of a long-acting nitrate and a beta blocker are especially effective in treating angina because: - Precise answer Nitrates increase MOS and beta blockers increase MOD Their additive affects permit lower doses of both drugs and their adverse reactions cancel each other out. They address the pathology of patients with exertional angina who have fixed atherosclerotic coronary heart disease Although they are often described as helpful in the lay media, which of the following therapies have not been shown to be helpful based on clinical evidence? - Precise answer Vitamins C and E Co-enzyme Q Folic acid Drug choices to treat angina in older adults differ from those of younger adults only in: - Precise answer Consideration of risk factors for diseases associated with and increased in aging Which of the following drugs has been associated with increased risk for myocardial infarction (MI) in women? - Precise answer Estrogen replacement
Treatments for heart failure, including drug therapy, are based on the stages developed by the ACC/AHA. Stage A patients are treated with: - Precise answer Drugs for hypertension and hyperlipidemia, if they exist Class I recommendations for Stage A heart failure include: - Precise answer Treatment of thyroid disorders, especially if they are associated with tachyarrhythmias Stage B patients should have beta blockers added to their heart failure treatment regimen when: - Precise answer They have an ejection fraction less than 40% They have had a recent MI Increased life expectancy for patients with heart failure has been associated with the use of: - Precise answer ACE inhibitors, especially when started early in the disease process Stage C patients usually require a combination of three to four drugs to manage their heart failure. In addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following statements about diuretics is NOT true? - Precise answer Diuretics from the potassium-sparing class should be used when using an ARB Digoxin has a very limited role in treatment of heart failure. It is used mainly for patients with: - Precise answer An audible S Which of the following classes of drugs is contraindicated in heart failure? - Precise answer CCB Heart failure is a leading cause of death and hospitalization in older adults (greater than 65 years old). The drug of choice for this population is: - Precise answer ACE inhibitors ACE inhibitors are contraindicated in pregnancy. While treatment of heart failure during pregnancy is best done by a specialist, which of the following drug classes are considered to be safe, at least in the later parts of pregnancy? - Precise answer Beta Blockers
Heart failure is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when: - Precise answer Symptoms markedly worsen or the patient becomes hypotensive and has syncope There is evidence of progressive renal insufficiency or failure The patient remains symptomatic on optimal doses of an ACE inhibitor, a beta blocker, and a diuretic Which of the following cardiac arrhythmias would not be amenable to treatment with digoxin (Lanoxin)? - Precise answer Premature ventricular contractions Despite good blood pressure control, a NP might change a patient's drug from an ACEI to an angiotensin II receptor blocker (ARB) because the ARB: - Precise answer Does not produce a dry, hacky cough ACE inhibitors are useful in a variety of disorders. Which of the following statements are true about both its usefulness in the disorder and the reason for its use? - Precise answer Stable angina because it decreases the thickening of vascular walls to decreased MOD. Heart failure because it reduces remodeling of injured myocardial tissues. Jacob has hypertension for which a calcium channel blocker has been prescribed. This drug helps control blood pressure because it: - Precise answer Decreases the amount of calcium inside the cell Which of the following adverse effects may occur due to a dihydropyridine- type calcium channel blocker? - Precise answer Edema of the hands and feet Patient teaching related to amlodipine includes: - Precise answer Avoid grapefruit juice as it affects the metabolism of this drug. Larry has heart failure which is being treated with digoxin because it exhibits: - Precise answer Netiher Negative inotropism Positive chronotropism
