Download RN PHARMACOLOGY EXAM STUDY GUIDE
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024 and more Exams Nursing in PDF only on Docsity!
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024.
Nurse is conducting DC teaching about anti-anxiety drug diazepam (valium) Evaluate the ingredients of all over-the-counter drugs for alcohol content
Nursing instruction most important for patient on Zyloprim Increase fluid intake
Client getting Tofranil (Imipramine) Give medication at night
Magnesium antidote Calcium gluconate
Patient with hyperthyroidism taking inderal (propanalol) Decreases pulse rate A client with hyperthyroidism is receiving propranolol (Inderal). Which finding indicates that the medication is having the desired effect?
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
- Decrease in serum T4 levels
- Increase in blood pressure - Decrease in pulse rate
- Goiter no longer palpable
Medication dosing-heparin 25000 units at 7ml/hr doctor changed rate to 900 units what is the Mls/hr
Med was ordered 100mg in 4 divided doses in 24 hours available in 25mg, how many will you give every 6 hours 1
Patient on benzos Answer is not narcan
- A client experiencing withdrawal from the benzodiazepines alprazolam (Xanax) is demonstrating severe agitation and tremors. What is the best initial nursing action?
- Administer naloxone (Narcan) per PNR protocol - Initiate seizure precautions
- Obtain a serum drug screen
- Instruct the family about withdrawal symptoms. - Rationale: Withdrawal of CNS depressants, such as Xanax, results in rebound over-excitation of the CNS. Since the client exhibiting tremors, the nurse should anticipate seizure activity and protect the client.
Patient Dx with bipolar-how to know if meds are effective Family states patient is doing better with manic phases
- A client with bipolar disorder began taking valproic acid (Depakote) 250 mg PO three times daily two months ago. Which finding provides the best indication that the medication regimen is effective? •The family reports a great reduction in client’s maniac behavior
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
Patient on Heparin going for surgery in a.m.,-priority Assess patient for bleeds
Best time to give patient Abx (I think) Time was like 1000, 1400, 1200, and 0400…best to give around the clock
Medication calculation-patient weighs equal to 16kg-order for Tamiflu 45mg BID Must round up-answer is 3.8ml
Peptic ulcer med-what action Histamine 2 agonist
Patient on folliculitis medication-what to teach Drink with full glass of water
Vasopressin Vasoconstrictor
Know why Digoxin and Lasix are used together
- Someone's on digoxin and Lasix how do you know the meds are working; is it because potassium is at 4, magnesium or something else
Tamoxifen Citrate use and therapeutic outcome
Fosomax for osteoarthritis patient teaching
- A female client receives a prescription for alendronate sodium (Fosamax) to treat her newly diagnose osteoporosis. W /hat instruction should the nurse include in the client’s teaching plan? - Take on an empty stomach with a full glass of water
Rifampin for TB Rusty-orange/red colored urine and body fluids
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
Pyridium for bladder infection Orange/red/pink urine
Stay in bed for 3 hours post first Ace Inhibitor dose
Avoid grapefruit juice with CCB
Lipitor (statins) in PM only-no grapefruit juice
Trough draw
- A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the nurse to obtain the trough level? A) Sixty minutes after the antibiotic dose is administered. B) Immediately before the next antibiotic dose is given. C) When the next blood glucose level is to be checked. D) Thirty minutes before the next antibiotic dose is given.
- Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose is given (B). (A, C, and D) do not describe the optimum time for obtaining a trough level of an antibiotic.
Peak draw 30-60 minutes after administration
Potassium sparing diuretic need to watch for hyperkalemia Aldactone (spirinolactone)
Using bronchodilators before steroids for asthma teaching Exhale completely, inhale deeply, hold breath for 10 seconds
Insulin can be kept at room temp 28 days
Drawing insulin Clear (regular) first then cloudy (NPH)
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
A nurse is giving morphine 2 mg IV to a pt after surgery and she has followed the “six rights of administration”… Know the possible reactions to morphine
RN doesn’t understand why a pt is to receive a prescribed med Verity the reason with the prescribing healthcare provider for use
Administration of schedule IV drug, the RN understands The drug has acceptable medical application with low potential for abuse
- A nurse is administering a drug that is categorized as Schedule IV. The nurse understands that this means the drug: A. Has acceptable medical applications with low potential for abuse B. Is a controlled sub with no accepted medical use C. Is dangerous to admin to pregnant or breast-feeding pts D. Has the potential for serious and life-threatening adverse effects
Where would a RN direct a pt to obtain more info about prescribed medications A pharmacist
RN is prepared to administer Epinephrine to pt that has a severe allergic reaction IV – no first pass effect
Digoxin has 36-48 hr half life – because of the length of half life, the RN expects to be dosing this medication Once a day
Pt is prescribed Cimetidine (histamine 2 antagonist) to treat gastric ulcer Inhibit the action of histamine at receptor sites and block gastric acid secretion
- When teaching a patient who has a gastric ulcer about cimetidine (a histamine H2 antagonist) therapy, the nurse should include which information about antagonists A. An antagonist causes a chemical reaction in the stomach B. An antagonist activates receptors in the stomach lining C. An antagonist prevents receptor activation in the stomach D. An antagonist improves receptor sensitivity in the stomach
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
Drug X has a therapeutic index of 10 and drug Y has an index of 2 Drug Y – more potent
A pt taking Digoxin is also prescribed Propanolol. The 2 drugs combined may cause a serious decrease in HR An increased adverse effect
A pt prescribed CCB Diltiazem to treat hypertension Grapefruit juice
- The nurse cares for a patient taking a calcium channel blocker for hypertension. The nurse is most concerned if the patient makes which statement? "I drink a glass of grapefruit juice each evening"
Which of the pts would be at highest risk for an adverse reaction An 84 yo with diabetes, HF, hypertension and takes 8 medications per day
RN receives a handwritten medication order – can’t read Contact prescriber to clarify order
A breast-feeding pt is prescribed an antimicrobial medication Take immediately after breast-feeding
The RN is evaluating the kidney fx of an 82 yo pt before administration of medications – Creatinine clearance – a measure of how the kidneys are fx by excreting creatinine. (BUN – good indicator of volume and dehydration) (Creatinine – is reflective very much by your BUN or level of hydration)
The most important factor in an adverse drug reaction in the elderly population is Declining renal fx
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
“This med will stop the progression of Parkinson’s.” – can’t cure Parkinson’s
Pt with mild symptoms of Alzheimer’s is prescribed Donepezil (Aricept) The drug will stop the damage to the neurons in my brain
- A patient with mild symptoms of Alzheimer's disease is prescribed donepezil (Aricept). Which statement made by the patient indicates a need for further teaching?
- "The drug will stop damage to the neurons in my brain." Donepezil will improve transmission by neurons in the brain because more acetylcholine will be availalble (it is a cholinesterase inhibitor), it may cause an upset stomach, and it is a good idea to take it at bed time because of the side effects. It will not, however, stop the damage in the brain, it only provides symptom control.
Pt is concerned about developing Alzheimer’s disease Naproxen (NSAID’s)
Which assessment best determines the effectiveness of Sumatriptan ( triptans are used for treatment of Migraines so… Termination of the migraine
Pt with schizophrenia is prescribed chlorpromazine (Thorazine – first generation antipsychotic) oral concentrate The medication may cause excessive salivation
- A patient with schizophrenia is prescribed chlorpromazine (Thorazine) oral concentrate. Which of the following discharge instructions should the nurse complete? A. Sexual arousal may be enhanced with this medication. B. Avoid direct skin contact with the medication. C. The medication may cause excessive salivation. D. Do not limit salt intake while taking the medication.
Which assessment best determines the pt is developing tardive dyskinesia Twisting, writhing, worm-like movements of tongue
Pt with depression is proscribed Fluoxitine (Prozac) “ It may take 3-4 weeks before my mood is elevated”
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
Pt is on Marplan (MAOIs – have the most food interactions) for depression Bananas, smoked fish, and cheese
Pt on Lithium Polydypsia (increased thirst), slurred speech, and fine hand tremors
Pt is prescribed Lunesta for insomnia Anterograde amnesia (memory loss of events right before taking drug)
A 24 yo female gets Triazolam (Halcion) for insomnia at home (remember to use the process of elimination) “The medication will not alter my breathing”
A pt is prescribed Venlafaxine and the pt asks what the purpose of medication is, you should state Depression and anxiety
A pt with OCD is prescribed Zoloft – which is not a true statement about the medication “I will get better in 3 weeks.” (full effect in 1 – 2 months, you won’t get “better” necessarily)
An RN is teaching a parent about administration of adderall to treat their child’s ADD Give the dose in the morning b4 school. (amphetamine – child needs it to concentrate)
Amphetamines can cause growth suppression in children Provide snack or meal b4 giving med (because amphetamines suppress appetite)
Pt states that he’s on Oxycodone and the dose that he currently receives does not provide the same pain relief Tolerance
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
A client who has been taking levadopa PO Tid to control the symptoms of Parkinson’s disease has a new prescription for sustained-release levadopa/carbidopa (Simemet 25/100) PO Bid and took his levadopa at 0800 “You can begin taking the Sinemet this evening, but do not take any more levadopa”
Which action is most important for the nurse to implement during the administration of the antiarrhythmic drug adenosine (Adenocard) Apply continuous cardiac monitoring
Nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related side effects. The nurse should prepare the client for which side effect that is most likely to persist during long-term use of opioids? Constipation
Which dosing schedule should the nurse teach the client to observe for a controlled release oxycodone Rx q12h
The healthcare provider prescribes digitalis (Digoxin) for a client Dx with congestive heart failure Assess the serum potassium level
- The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with congestive heart failure. Which intervention should the nurse implement prior to administering the digoxin? A. Observe resp rate and depth B. assess the serum potassium level C. Obtain the clients blood pressure D. Monitor the serum glucose level
- hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin
Which method of medication administration provides the client with the greatest first pass effect Oral
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
- The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism in the liver. After oral (A) medications are absorbed from the gastrointestinal tract, the drug is carried directly to the liver via the hepatic portal circulation where hepatic inactivation occurs and reduces the bioavailability of the drug. Alternative method of administration, such as sublingual (B), IV (C), and subcutaneous (D) routes, avoid this first-pass effect.
Most important when caring for a client receiving the antimetabolite cytosine arabinoside (ARC-C) for chemotherapy Inspect the clients’ oral mucosa for ulcerations
- Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore stomatitis and mucosal ulcerations are key signs of antimetabolite toxicity
Identify as being at high risk for complications during the use of an opioid analgesic A young adult with inflammatory bowel Dz
- Which client should the nurse identify as being at the highest risk for complications during the use of an opioid analgesic? A. an older client with type 2 diabetes B. A client with chronic rheumatoid arthritis C. A client with a open compound fracture D. A young adult with inflammatory bowel disease
Rheumatoid arthritis takes ibuprophin (Motrin) 600 mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed Which information is most important for the nurse to include in client teaching? Use contraception during intercourse
- Cytotec, a synthetic form of prostaglandin, is classified as pregnancy category X and can act as an abortifacient, so the client should be instructed to use contraception during intercourse to prevent loss of early pregnancy
Receiving methylprednisolone (Solu-Medrol) 40 mg IV daily anticipates an increase in which lab value Serum glucose
- A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse anticipates an increase in which laboratory value as the result of this medication? A) Serum glucose. B) Serum calcium.
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
again requesting pain medication. What intervention should the nurse implement? Administer only the Dilaudid q4h PRN for pain
Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for which condition Heart failure
- Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac decompensation or heart failure (D) related to reduced cardiac contractility due to organic heart disease or cardiac surgical procedures. Alpha and beta adrenergic agonists, such as epinephrine and dopamine, are sympathomimetics used in the treatment of shock (A). Other selective beta- adrenergic agonists, such as terbutaline and isoproterenol, are indicated in the treatment of asthma (B). Although dobutamine improves cardiac output, it is not used to treat hypotension (C).
Giardiasis is taking metronidazole (Flagyl) 2 grams PO Take the medication with food
- A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse include in the client's instruction? A) Notify the clinic of any changes in the color of urine. B) Avoid overexposure to the sun. C) Stop the medication after the diarrhea resolves. D) Take the medication with food.
- Flagyl, an amoebicide and antibacterial agent, may cause gastric distress, so the client should be instructed to take the medication on a full stomach (D). Urine may be red-brown or dark from Flagyl, but this side effect is not necessary to report (A). Photosensitivity (B) is not a side effect associated with Flagyl. Despite the resolution of clinical symptoms, antiinfective medications should be taken for their entire course because stopping the medication (C) can increase the risk of resistant organisms.
The nitrate isosorbide denitrate (Isordil) is prescribed for a client with angina Do not get up quickly, always rise slowly
- The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? A) Quit taking the medication if dizziness occurs. B) Do not get up quickly. Always rise slowly. C) Take the medication with food only. D) Increase your intake of potassium-rich foods.
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
- An expected side effect of nitrates is orthostatic hypotension and the nurse should address how to prevent it--by rising slowly (B). Dizziness is expected, and the client should not quit taking the medication without notifying the healthcare provider (A). (C and D) are not indicated when taking this medication.
Reviewing the use of the patient controlled analgesics (PCA) pump with a client in the immediate postoperative period The client will receive Morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximally per hour The rate and depth of the clients’ respirations
- The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the immediate postoperative period. The client will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximally per hour. What assessment has the highest priority before initiating the PCA pump? A) The expiration date on the morphine syringe in the pump. B) The rate and depth of the client's respirations. C) The type of anesthesia used during the surgical procedure. D) The client's subjective and objective signs of pain.
- A life-threatening side effect of intravenous administration of morphine sulfate, an opiate narcotic, is respiratory depression (B). The PCA pump should be stopped and the healthcare provider notified if the client's respiratory rate falls below 12 breaths per minute, and the nurse should anticipate adjustments in the client's dosage before the PCA pump is restarted. (A, C, and D) provide helpful information, but are not as high a priority as the assessment described in (B).
A peak and trough level must be drawn for a client receiving antibiotic therapy Immediately before the next antibiotic dose is given
When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is most important for the nurse to assess for pain in which area of the body Abdomen
- Acetaminophen toxicity can result in liver damage; therefore, it is especially important for the nurse to assess for pain in the right upper quadrant of the abdomen (B), which might indicate liver damage. (A, C, and D) are not areas where pain would be anticipated.
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
the risk of esophageal reflux and irritation. (A) is the best schedule to meet these needs. (B, C, and D) do not meet these criteria.
Continuous IV infusion of dopamine (Intiropin) and an IV of normal saline at 50 ml/hr the nurse notes that the clients urinary output has been 20 ml/hr for the last 2 hours Notify the healthcare provider of the urinary output
Which change in data indicates to the nurse that the desired effect of the angiotension II receptor antagonist valsartan (Diovan) has been achieved Blood pressure reduced from 160/90 to 130/
- Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan (Diovan) has been achieved? A) Dependent edema reduced from +3 to +1. B) Serum HDL increased from 35 to 55 mg/dl. C) Pulse rate reduced from 150 to 90 beats/minute. D) Blood pressure reduced from 160/90 to 130/80.
- Diovan is an angiotensin receptor blocker, prescribed for the treatment of hypertension. The desired effect is a decrease in blood pressure (D). (A, B, and C) do not describe effects of Diovan.
A healthcare provider prescribes cephalexin monohydrate (Keflex) for a postoperative infection Penicillins
- A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with a postoperative infection. It is most important for the nurse to assess for what additional drug allergy before administering this prescription? A) Penicillins. B) Aminoglycosides. C) Erythromycins. D) Sulfonamides.
- Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin monohydrate (Keflex), so checking for penicillin allergy is a wise precaution before administering this drug.
Prescription for a scopolamine patch (Transderm Scop) to prevent motion sickness while on a cruise Apply the patch at least 4 hrs prior to departure
- Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a peak onset in 6 hours, so the client should be instructed to apply the patch at least 4 hours before departure (A) on the cruise ship. The
TOP RATED EXAM STUDY GUIDE LATEST UPDATED 2024
duration of the transdermal patch is 72 hours, so (B) is not needed. Scolopamine blocks muscarinic receptors in the inner ear and to the vomiting center, so the best application site of the patch is behind the ear, not at the base of the skull (C). Anticholinergic medications are CNS depressants, so the client should be instructed to avoid alcohol (D) while using the patch.
Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis Bismuth subsalicylate (Pepto Bismol)
- Bismuth subsalicylate (Pepto Bismol) contains a subsalicylate that increases the potential for salicylate toxicity when used concurrently with aspirin (acetylsalicylic acid, another salicylate preparation). (A, B, and D) do not pose the degree of risk of drug interaction with aspirin as Pepto Bismol would.
Prescriptions for morphine sulphate 2.5 mg IV q6h and ketorolac (Toradol) 30 mg IV q6h administer both medications according to the prescription
- An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (Toradol) 30 mg IV q6h. Which action should the nurse implement? A) Administer both medications according to the prescription. B) Hold the ketorolac to prevent an antagonistic effect. C) Hold the morphine to prevent an additive drug interaction. D) Contact the healthcare provider to clarify the prescription.
- Morphine and ketorolac (Toradol) can be administered concurrently (A), and may produce an additive analgesic effect, resulting in the ability to reduce the dose of morphine, as seen in this prescription. Toradol is an antiinflammatory analgesic, and does not have an antagonistic effect with morphine (B), like an agonist-antagonist medication would have. An additive analgesic effect is desirable (C), because it allows a reduced dose of morphine. This prescription does not require any clarification, and can be administered safely as written (D).
Hyperlipidemia receives a prescription for niacin (Niaspan) Expected duration of flushing
- A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide? A) Expected duration of flushing. B) Symptoms of hyperglycemia. C) Diets that minimize GI irritation. D) Comfort measures for pruritis. - Flushing of the face and neck, lasting up to an hour, is a frequent reason for discontinuing niacin. Inclusion of this effect in client teaching (A) may promote compliance in taking the medication.
