Pharm2 – Flashcard
70 test answers
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A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?
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-ACE inhibitor
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A patient with type 2 diabetes mellitus has been found to have trace proteinuria in their urine. The prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reason for prescribing this class of drug for this patient?
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-renal protective
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The nurse is reviewing the orders for a patient and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class?
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NSAIDs
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An elderly patient will be taking a vasodilator for hypertension. Which adverse effect is of most concern for the older adult patient taking this class of drug?
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-orthostatic hypotension
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When the nurse is administering topical nitroglycerin ointment, which technique is correct?
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-wipe off the old and put on the new and wear gloves
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A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction?
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-If chest pain isn't relieved then call emergency after first tablet
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A calcium channel blocker (CCB) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. Which instruction is correct?
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-high fiber diet with plenty of fluids
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A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?
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-it can mask the symptoms of hyperglycemia or hypoglycemia
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What action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?
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-take off the patch at night, have 8 hours with a nitrate free period
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While assessing a patient who is taking a beta blocker for angina, the nurse knows to monitor for which adverse effect?
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-bradycardia
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When teaching a patient who has a new prescription for transdermal nitroglycerin patches, the nurse tells the patient that these patches are most appropriately used for which situation?
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-angina
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A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/minute. What will the nurse do next?
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-not give and call the doctor
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A patient is taking digoxin (Lanoxin) and a loop diuretic (furosemide/Lasix) daily. When the nurse enters the room with the morning medications, the patient states, "I am seeing a funny yellow color around the lights." What is the nurse's next action?
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-assess for dig. toxicity
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While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the patient?
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-decreases heart rate
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Positive inotropic effect
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increase the force of myocardial contraction
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Positive chronotropic drugs
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-increase heart rate
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Positive dromotropic drugs
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Accelerate cardiac conduction
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A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digifab). The patient asks the nurse why the medication is ordered. What is the nurse's best response?
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-antidote to digoxin and will help lower the drug levels
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Appropriate serum level for digoxin
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0.5-2
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A patient has been placed on a milrinone (Primacor) infusion as part of the therapy for end-stage heart failure. What adverse effect of this drug will the nurse watch for when assessing this patient during the infusion?
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-dysrhythmias
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A patient has a digoxin level of 1.4 ng/mL. The nurse interprets that this level is
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within therapeutic range
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The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin) therapy. The nurse will teach the patient to avoid which foods when taking the digoxin?
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-bran muffins (fiber)
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In assessing a patient before administration of a cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug?
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-potassium level 2.8 which is supposed to 3.5-5
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The nurse administering the phosphodiesterase inhibitor milrinone (Primacor) recognizes that this drug will have a positive inotropic effect. Which result reflects this effect?
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-increase the force of myocardial contraction
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A patient is taking procainamide (Pronestyl) for a cardiac dysrhythmia. The nurse will monitor the patient for which possible adverse effect
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-prolongs QT interval, and diarrhea
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A 62-year-old man is to receive lidocaine as treatment for a symptomatic dysrhythmia. Upon assessment, the nurse notes that he has a history of alcoholism and has late-stage liver failure. The nurse will expect which adjustments to his drug therapy?
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-the doses will be reduced by 50%
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A patient has been started on therapy of a continuous infusion of lidocaine after receiving a loading dose of the drug. The nurse will monitor the patient for which adverse effect?
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-convulsions
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A patient is receiving an aluminum-containing antacid. The nurse will inform the patient to watch for which possible adverse effect?
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-constipation
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A patient who has been taking cimetidine (Tagamet) for hyperacidity calls the clinic to say that the medication has not been effective. The nurse reviews his history and notes that which factor may be influencing the effectiveness of this drug?
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-smoking
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A patient is complaining of excessive and painful gas. The nurse checks the patient's medication orders and prepares to administer which drug for this problem?
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-simethicone
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A 75-year-old woman comes into the clinic with complaints of muscle twitching, nausea, and headache. She tells the nurse that she has been taking sodium bicarbonate 5 or 6 times a day for the past 3 weeks. The nurse will assess for which potential problem that may occur with overuse of sodium bicarbonate?
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-metabolic alkalosis
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A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?
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GOlytely (hyperosmotic)
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A patient asks the nurse about the difference between diphenoxylate with atropine (Lomotil) and the over-the-counter drug loperamide (Imodium). Which response by the nurse is correct?
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Imodium does not cause physical dependence because lomotil is opiod and imodium is over the counter
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A patient wants to prevent problems with constipation and asks the nurse for advice about which type of laxative is safe to use for this purpose. Which class of laxative is considered safe to use on a long-term basis?
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-bulk forming, metamucil and citrucel
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A patient is severely constipated and needs immediate relief. The nurse knows that which class of laxative will provide the most rapid results?
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Magnesium hydroxide
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A 22-year-old patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory result is correct
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the lithium level is therapeutic -loop diuretic
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A patient wants to take a ginseng dietary supplement. The nurse instructs the patient to look for which potential adverse effect?
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-palpations and anxiety
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A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse's response is based on which rationale?
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Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels
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A patient is receiving thrombolytic therapy, and the nurse monitors the patient for adverse effects. What is the most common undesirable effect of thrombolytic therapy?
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-internal and superficial bleeding
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A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote?
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-vitamin K
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A patient will be receiving a thrombolytic drug as part of the treatment for acute myocardial infarction. The nurse explains to the patient that this drug is used for which purpose?
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To dissolve the clot in the coronary artery
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A patient who is taking warfarin (Coumadin) therapy has a headache and calls the prescriber's office to ask about taking a pain reliever. The nurse expects to receive instructions for which type of medication?
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acetaminophen (Tylenol)
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A patient has had recent prosthetic heart valve surgery and is receiving anticoagulant therapy. While monitoring the patient's laboratory work, the nurse interprets that the patient's international normalized ratio (INR) level of 2.5 indicates that
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Pt's warfarin dose is at therapeutic levels
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A patient has received an overdose of intravenous heparin, and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose?
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-protamine sulfate
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he nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics?
answer
Spironalactone
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Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure
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Intravenously, through a filter; Osmotic diuretic; can crystalized in cold temperatures and IV only, and it is stored in a warmer in pharmacy. Pregnancy C drug
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Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
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be sure to change your position slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes
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When monitoring a patient who is taking hydrochlorothiazide (HydroDIURIL), the nurse notes that which drug is most likely to cause a severe interaction with the diuretic?
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There is an increased risk for digitalis toxicity in the presence of hypokalemia, which may develop with hydrochlorothiazide therapy. Potassium supplements are often prescribed with hydrochlorothiazide therapy to prevent hypokalemia. The other options do not have interactions with hydrochlorothiazide.
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When a patient is receiving diuretic therapy while in a hospital, which of these assessment measures would best reflect the patient's fluid volume status
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Intake, output, and daily weight
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A patient is being discharged to home on a single daily dose of a diuretic. The nurse instructs the patient to take the dose at which time so it will be least disruptive to the patient's daily routine?
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-morning
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A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure?
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-Mannitol
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When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action?
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Dextromethorphan suppresses the cough reflex through a direct action on the cough center. The other options are not correct
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During a routine checkup, a patient states that she is unable to take the prescribed antihistamine because of one of its most common adverse effects. The nurse suspects that which adverse effect has been bothering this patient
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-drowsiness
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A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching?
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Force fluids to help loosen and liquefy secretions.
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A patient with a tracheostomy has difficulty removing excessive, thick mucus from the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of mucus?
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guaifenesin (Mucinex)
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The nurse is reviewing the use of antitussive drugs. Antitussive drugs would be most appropriate for which patient?
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-nonproductive cough
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A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive pulmonary disease. The nurse will assess for which therapeutic response?
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-increased easy of breathing
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A patient is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease. The nurse will monitor for adverse effects associated with the use of xanthine derivatives, such as
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-palpitations
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A patient is in an urgent-care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment?
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A beta2 agonist such as albuterol (Proventil)
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The prescriber has changed the patient's medication regimen to include the leukotriene receptor antagonist montelukast (Singulair) to treat asthma. The nurse will emphasize which point about this medication?
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It should be taken every day on a continuous schedule, even if symptoms improve.
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After receiving a nebulizer treatment with a beta agonist, the patient complains of feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse's best response?
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This is an expected adverse effect. Let me take your pulse."
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A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?
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The bronchodilator should be taken first."
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When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects?
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-oral candisis, dry mouth
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When evaluating a patient's use of a metered-dose inhaler (MDI), the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing. What intervention is most appropriate at this time?
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-use a spacer
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The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate?
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It is used for prevention of bronchospasms.
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Which drug classes are commonly used as over-the-counter (OTC) remedies? (Select ALL that apply)
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-Nonsteroidal antiinflammatory drugs -Cold remedies -Smoking deterrent systems -Histamine 2 (H2) blockers
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