Ati nurs 180 pharmacology final exam
Total Questions : 67
Showing 25 questions, Sign in for moreA client is receiving Total Parenteral Nutrition (TPN) while admitted in the inpatient setting. Which of the following conditions can occur if the nurse abruptly stops TPN?
Explanation
A. Diarrhea is not a direct risk of stopping TPN abruptly.
B. Abruptly stopping TPN can cause hypoglycemia because the high glucose content in TPN leads to increased insulin production. Without the continuous glucose infusion, blood sugar levels can drop rapidly.
C. Hypovolemia is not a common outcome from stopping TPN suddenly.
D. Erythema at the site is unrelated to the cessation of TPN and more commonly related to local site reactions or infection.
The nurse is caring for an 18-year-old client who has recently been prescribed montelukast. Which statement made by the client indicates understanding of the newly prescribed medication?
Explanation
A. Anaphylaxis is not a common side effect of montelukast.
B. Regular blood monitoring is not required with montelukast.
C. Montelukast is a leukotriene receptor antagonist, used for long-term management of asthma and to prevent exercise-induced bronchoconstriction.
D. Montelukast is not intended for immediate relief or repeated dosing in acute situations.
A client is taking pyridostigmine for muscle weakness associated with myasthenia gravis. The nurse educates the client on which possible cholinergic side effects associated with this medication? (Select all that apply)
Explanation
A. Dry mouth is not a cholinergic side effect; cholinergic effects typically increase secretions.
B. Diarrhea is a common cholinergic side effect due to increased gastrointestinal motility.
C. Decreased urination is not expected; cholinergic agents may increase urination.
D. Excessive lacrimation (tearing) is a common cholinergic effect, as these agents stimulate glandular secretions.
E. Tachycardia is not a cholinergic side effect; bradycardia is more likely due to cholinergic effects.
F. Excessive sweating is a cholinergic effect due to increased glandular activity.
The nurse is caring for a client currently taking oxymetazoline. Which of the following statements should the nurse include regarding oxymetazoline?
Explanation
A. Oxymetazoline should not be used for more than 3 days because prolonged use can lead to rebound congestion.
B. Oxymetazoline typically does not cause drowsiness, so taking it at bedtime is not necessary.
C. Oxymetazoline has a rapid onset and should not take a week to show effects.
D. Oxymetazoline is a nasal decongestant and is not used for asthma management.
A client newly prescribed niacin (Nicotinic Acid) presents to the healthcare setting with complaints of flushing following doses. Which of the following medications would the nurse anticipate being administered?
Explanation
A. Beta blockers are used to manage blood pressure and heart rate but are not effective in reducing niacin-induced flushing.
B. Calcium channel blockers help to relax blood vessels but do not address the flushing side effect caused by niacin.
C. NSAIDs, like aspirin, can help reduce the flushing associated with niacin. This flushing occurs due to prostaglandin release, which NSAIDs can inhibit.
D. While fibric acid derivatives are used to lower cholesterol, they do not alleviate the flushing side effect of niacin.
A client is prescribed antibiotics while pending the results of their wound culture. The nurse understands this method of medication therapy is known as:
Explanation
A. Prophylactic therapy is used to prevent infection in at-risk individuals, not to treat suspected infections before confirming lab results.
B. Palliative therapy is intended for symptom relief, often in cases where curing the disease is not the goal.
C. Maintenance therapy is designed to maintain health stability rather than to treat suspected infections without lab confirmation.
D. Empiric therapy involves starting treatment based on clinical judgment before lab results are available. This approach is useful to manage infections promptly when waiting for cultures could delay necessary care.
A client diagnosed with strep throat requires antibiotics for treatment. With an allergy to penicillin, the nurse understands which medication should be avoided due to cross-sensitivity with penicillin medications?
Explanation
A. Macrolides, such as azithromycin and erythromycin, have a low cross-reactivity with penicillin and are typically safe alternatives for those with penicillin allergies.
B. Sulfonamides are not structurally similar to penicillins and generally do not have cross-sensitivity issues with penicillin allergies.
C. Cephalosporins share a similar beta-lactam structure to penicillins, which can result in cross-sensitivity in some individuals with a penicillin allergy. For this reason, they should be avoided or used with caution in these clients.
D. Tetracyclines have a different structure from penicillins and are usually safe for clients with penicillin allergies.
A nurse reads in a drug information guide that PO morphine has a high first-pass effect. Which of the following would the nurse expect?
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.
A nurse is assessing a client who is lethargic, diaphoretic, and difficult to arouse. The client's blood sugar result was 40 mg/dL. The nurse anticipates which of the following to be administered?
Explanation
A. Glucose tablets are appropriate for clients with mild hypoglycemia who are alert and able to chew and swallow; they are not suitable for someone who is difficult to arouse.
B. Epinephrine is not used as a treatment for hypoglycemia; it does not directly increase blood glucose levels.
C. IVP (intravenous push) dextrose 50% is indicated for severe hypoglycemia in clients who are lethargic or unresponsive, as it rapidly increases blood glucose levels.
D. Orange juice is effective for mild hypoglycemia but is not appropriate in this case due to the client’s altered mental status and risk of aspiration.
A client diagnosed with trichomoniasis is prescribed metronidazole (Flagyl). The nurse should instruct the client to avoid which contraindication associated with this medication?
Explanation
A. Grapefruit juice does not have a known interaction with metronidazole and does not need to be avoided.
B. Dairy does not interfere with metronidazole's absorption or effectiveness, so it is not a contraindication.
C. Alcohol should be strictly avoided during and for at least 48 hours after metronidazole treatment, as it can cause a severe reaction, including nausea, vomiting, flushing, and rapid heart rate.
D. Tyramine-based foods do not interact with metronidazole, so they are not a contraindication for this medication.
A client's severe asthma has necessitated the use of a long-acting beta2-agonist (LABA). Which of the client's statements suggests a need for further education?
Explanation
A. LABAs can help prevent asthma attacks, including those triggered by exercise, so this statement is accurate and does not indicate a need for further education.
B. LABAs may cause side effects like an increased heart rate, which the client correctly recognizes.
C. LABAs are not intended for immediate relief of asthma symptoms; they are for long-term control. A short-acting beta2-agonist (SABA) should be used for acute symptoms, indicating this client needs further education.
D. Over time, tolerance can develop with some medications, and this understanding is accurate, so it does not indicate a need for additional teaching.
The nurse is preparing to administer digoxin (Lanoxin) to a client experiencing atrial fibrillation. Which of the following electrolyte imbalances would the nurse assess to reduce the incidence of toxicity with digoxin (Lanoxin)?
Explanation
A. Hypokalemia increases the risk of digoxin toxicity because low potassium levels enhance digoxin's effects on the myocardium. Monitoring and correcting potassium levels is essential in clients on digoxin.
B. Hypophosphatemia is not directly linked to digoxin toxicity and is not a primary concern.
C. Hypocalcemia does not increase the risk of digoxin toxicity; in fact, hypercalcemia would be more concerning in terms of potential toxicity.
D. Hypernatremia does not have a significant effect on digoxin toxicity, so it is not a primary concern when assessing this medication’s safety.
A nurse is caring for a client who has been taking phenytoin (Dilantin). The nurse understands that which of the following is a long-term adverse effect of this medication?
Explanation
A. Hair loss is not a recognized long-term side effect of phenytoin.
B. Phenytoin is used to prevent seizures, not cause them; a reoccurrence of seizures may indicate ineffective control or medication issues, but it is not a side effect.
C. Hypertension is not typically associated with phenytoin use.
D. Gingival hyperplasia, or overgrowth of gum tissue, is a common long-term side effect of phenytoin and requires regular dental hygiene and monitoring.
A client frequently takes diphenhydramine (Benadryl) to alleviate his upper respiratory symptoms associated with allergies. Which of the following mechanisms of action applies to diphenhydramine (Benadryl)?
Explanation
A. Diphenhydramine is an H1 antihistamine that works by blocking the effects of histamine at H1 receptor sites, thus alleviating allergy symptoms.
B. H2 receptor sites are primarily involved in gastric acid secretion, and diphenhydramine does not affect these receptors.
C. Diphenhydramine does not stimulate histamine effects; it blocks them instead.
D. The medication does not occupy all H receptor sites; it specifically targets H1 receptors to exert its effects.
A client presents to the healthcare setting with a diagnosis of chronic liver failure. The nurse understands this will affect which step of pharmacokinetics?
Explanation
A. While liver failure may affect excretion indirectly, it primarily impacts metabolism more significantly.
B. Absorption is typically not directly affected by liver function, though it can be influenced by other factors.
C. The liver is crucial for drug metabolism; chronic liver failure impairs the liver's ability to metabolize medications effectively, leading to potential toxicity.
D. Distribution may be altered due to changes in plasma proteins or blood flow, but the most significant impact occurs in metabolism.
A client presents to the healthcare setting with a diagnosis of emphysema. Which of the following medications below would be contraindicated with the client's allergy to soybeans?
Explanation
A. Methylprednisolone does not contain soy products and is not contraindicated for clients with a soybean allergy.
B. Ipratropium bromide is often formulated with soy lecithin as a stabilizer, making it contraindicated for individuals allergic to soybeans.
C. Montelukast is a leukotriene receptor antagonist and does not contain soy products, so it is safe for this client.
D. Albuterol does not contain soy products and is generally safe for clients with a soybean allergy.
The nurse is caring for a client currently taking a combination birth control pill for contraception prevention. Which adverse effect would the nurse closely monitor for associated with this medication?
Explanation
A. While hormonal contraceptives can affect blood pressure, the risk of significant hypertension is less immediate than thromboembolism.
B. Dysfunctional uterine bleeding can occur but is generally not as serious as thromboembolism and may resolve with continued use.
C. Combination birth control pills increase the risk of thromboembolic events, such as deep vein thrombosis (DVT) and pulmonary embolism, making it essential to monitor for signs of these complications.
D. Osteoporosis is a long-term concern but is not an acute effect of combination birth control pills; monitoring for thromboembolism is more critical.
The nurse is administering an estrogen blocker to a client diagnosed with advanced breast cancer. Which of the following side effects will the nurse caution the client regarding?
Explanation
A. Estrogen blockers can increase the risk of thromboembolic events, including deep vein thrombosis and pulmonary embolism, which the nurse should caution the client about.
B. Tendon rupture is more commonly associated with certain antibiotics and corticosteroids, not typically with estrogen blockers.
C. Photosensitivity is not a common side effect associated with estrogen blockers; it is more related to specific antibiotics or other medications.
D. While some malignancies can be linked to immunosuppressive therapies, the direct risk of lymphomas is not typically associated with estrogen blockers.
A client has been taking propylthiouracil (PTU) for 8 weeks. Which statement by the client would indicate the drug is having its desired effects? (Select all that apply).
Explanation
A. Bruising is typically related to anticoagulant effects or blood disorders and not directly tied to the desired effects of PTU.
B. Improved sleep is an indicator that hyperthyroidism symptoms, such as insomnia, are being managed effectively.
C. A decrease in anxiety can suggest effective management of hyperthyroidism, as anxiety is a common symptom of this condition.
D. Weight loss or inability to gain weight is usually a symptom of hyperthyroidism, so this statement would indicate that PTU is not achieving the desired effect.
E. A return to regular menstruation can indicate improved thyroid function, as hyperthyroidism can disrupt menstrual cycles.
F. Reduced heart rate and the absence of palpitations suggest effective management of hyperthyroidism symptoms, indicating the drug is having the desired effect.
A client recently diagnosed with Iron deficiency Anemia is prescribed Ferrous Sulfate daily. Which of the following statements below is true regarding iron therapy?
Explanation
A. Ferrous sulfate can stain the teeth; therefore, using a straw can help minimize this risk when taken in liquid form.
B. Iron absorption is actually reduced when taken with milk or dairy products due to calcium binding with iron, so this statement is incorrect.
C. Iron supplements are often associated with constipation, and taking them at night may not prevent this issue; in fact, taking them during the day with plenty of fluids and fiber is usually recommended.
D. Antacids can interfere with the absorption of iron, so it is not advisable to take them together.
The nurse is caring for a patient who is currently receiving oxytocin (Pitocin). What will the nurse anticipate as an expected outcome of this medication?
Explanation
A. Oxytocin is primarily used to induce or augment labor in full-term clients, making this the correct statement regarding its expected outcome.
B. Oxytocin is not used to prevent contractions; it is used to stimulate them, especially during labor.
C. Oxytocin is not a contraceptive; it does not prevent pregnancy but is used in labor management.
D. Oxytocin does not influence egg production; it primarily affects uterine contractions and milk ejection in breastfeeding.
A nurse is caring for a client who is currently 34-weeks gestation. Which of the following medications would be avoided due to its category X classification?
Explanation
A. Morphine is a category C medication, which means it may be used if the benefits outweigh the risks; it is not contraindicated in pregnancy.
B. Famotidine (Pepcid) is also a category B medication and is generally considered safe to use during pregnancy.
C. Misoprostol (Cytotec) is classified as category X due to its association with causing uterine contractions and the potential for fetal harm; thus, it should be avoided during pregnancy.
D. Ibuprofen (Advil) is a category C medication, and while it is not typically recommended in the third trimester, it is not classified as category X.
A diabetic client who is currently taking metformin is ordered a computerized tomography (CT) scan with contrast. The nurse understands that the client's metformin should be discontinued how many hours before receiving intravenous (IV) contrast?
Explanation
A. Discontinuing metformin 24 hours before a CT scan is longer than necessary and not standard practice.
B. It is generally recommended that metformin be held for at least 12 hours before the administration of IV contrast to reduce the risk of lactic acidosis, especially in clients with renal impairment.
C. Six hours is insufficient time to ensure the medication is cleared from the system, considering the potential risks.
D. Discontinuing metformin for 48 hours is overly cautious and not necessary unless there are complications that arise after the contrast is administered.
A client who suffers from hypertension and headaches is prescribed propranolol. The nurse would educate the client on which side effects associated with this medication?
Explanation
A. Rebound hypotension is more commonly associated with abrupt withdrawal of beta-blockers rather than a direct side effect, so it is not typically included as a side effect to expect while on the medication.
B. Vomiting is not a common side effect associated with propranolol; the nurse would not educate the client on this.
C. Bradycardia is a known side effect of propranolol, as it is a beta-blocker that decreases heart rate, so clients should be educated about monitoring their heart rate.
D. Tremors can be related to withdrawal from beta-agonists rather than propranolol, which may alleviate tremors in some individuals; thus, it's not a common side effect of the medication.
E. Propranolol can mask the symptoms of hypoglycemia (e.g., tachycardia), making it important for clients with diabetes to be aware of this potential effect.
F. Bronchoconstriction can occur in clients with reactive airway diseases, as propranolol non-selectively blocks beta receptors, so clients should be educated about this risk, especially if they have asthma or other pulmonary conditions.
A nurse is preparing to administer a medication to a client who states, "That looks different from the pill I usually take." Which is the best response by the nurse?
Explanation
A. Asking what the usual pill looks like may not provide clarity and does not address the client's concern directly.
B. While the statement is accurate, it does not provide the client with reassurance or address the reason for the difference in appearance.
C. This response acknowledges the client's concern, offers an explanation about variations in medication appearance due to different manufacturers, and reassures the client that it is the same medication prescribed.
D. Suggesting that the pill is from a different lot number does not address the fact that variations in appearance can occur due to different manufacturers, which is more common and relevant to the situation.
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