A 77-year-old man’s chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? NURS – 6521N Advanced Pharmacology Midterm Exam
|The man’s glomerular filtration rate and creatinine levels are within reference ranges.|
|The man’s heart rate is between 60 and 70 beats per minute with a regular rhythm.|
|The man’s potassium and sodium levels remain with reference ranges.|
|The man’s chest sounds are clear and his ankle edema is lessened.|
Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?
|The resident has not eaten breakfast because of a recent loss of appetite|
|The resident’s apical heart rate is 112 beats/minute with a regular rhythm|
|The resident had a fall during the night while transferring from her bed to her bathroom|
|The resident received her annual influenza vaccination the previous day|
To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should
|administer calcium supplements.|
|position the patient in the side-lying position.|
|monitor for nausea and vomiting.NURS – 6521N Advanced Pharmacology Midterm Exam|
Which statement is FALSE regarding the treatment of hyperthyroidism?
|Long-acting beta-blocking agents are given as adjunctive therapy until Propulthiouracil (PTU) or methimazole (Tapazole) restores the patient to euthyroid|
|Methimazole (Tapazole) is the drug of choice for pregnant or lactating females.|
|Propylthiouracil (PTU) reduces peripheral conversion of T4 to the more potent T3|
|Since methimazole (Tapazole) is stronger than Propylthiouracil (PTU), Methimazole should be initiated at 15 mg/day compared to 300 mg/day for Propylthiouracil for treatment of mild disease|
A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient’s medication regimen. Which of the patient’s medications should prompt the nurse to teach her to avoid drinking grapefruit juice?
A 65-year-old male presents with a history of worsening urinary urgency, frequency, and hesitancy. He also tells you that he has to “push really hard” to urinate and that his urine dribbles a little after he is done urinating. What medication should be avoided NURS – 6521N Advanced Pharmacology Midterm Exam
A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. Whare is the most serious potential adverse effect of this medication?
Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?
|A man who is in cardiogenic shock following a myocardial infarction|
|A man who has a diagnosis of primary hypertensionNURS – 6521N Advanced Pharmacology Midterm Exam|
|A woman who has been admitted with a suspected ischemic stroke|
|A woman who is in labor and may require a caesarean section|
A male patient who is hypertensive takes Hydrochlorothiazide for his blood pressure . He presents with red, painful swelling of the great toe. In addition to treating gout, you recognize that you may need to:
|Increase his HCTZ|
|Order laboratory studies for diabetes|
|Change his thiazide antihypertensive medication|
|Advise him to lose weight|
A patient has been prescribed a drug that can be self-administered at home. NURS – 6521N Advanced Pharmacology Midterm Exam. Which of the following would be the most important information for the nurse to relate to the patient concerning self-administration of a drug?
|Where to purchase the medication|
|The cost of the drug|
|The therapeutic effects and possible adverse effects|
|The pharmacokinetics of the drug|
A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse’s advice?
|Integrating the new drug into the patient’s existing schedule promotes adherence.|
|Combining a new drug with one or more existing drugs mitigates the risk of adverse effects.|
|Taking several drugs at one time maximizes recovery time for the liver and kidneys.|
|Rapid drug clearance fostered when a patient is able to minimize the number of drug administration times.|
A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. NURS – 6521N Advanced Pharmacology Midterm Exam. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to
|the impact of the placebo effect on the patient’s response.|
|the accumulative effect of the drug if it has been taken for many years.|
|the impact of the warmer climate on the patient’s physical state.|
|problems with patient compliance with the drug regimen due to the move.|
A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be
A patient with unstable angina pectoris who is NOT controlled with a nitrate would likely benefit most from the addition of:
|1.||Sodium channel blocker|
|4.||Either 1 or 2|
When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are:
|Diuretics and calcium channel blockers.|
|Diuretics and beta blockers.|
|Calcium channel blockers and ACE inhibitors.|
|Alpha blockers and ACE inhibitors. NURS – 6521N Advanced Pharmacology Midterm Exam|
A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to
|crush the tablet before swallowing.|
|swallow the tablet whole. NURS – 6521N Advanced Pharmacology Midterm Exam|
|swallow the tablet with milk or food.|
|avoid drinking milk for 3 hours after swallowing the tablet.|
A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain?
|Call the physician|
|Ask the patient to lie back and try to relax|
|Have the patient swallow a tablet every 5 minutes for 15 minutes|
|Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided|
After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient?
|“Make sure that you take this at the scheduled times, regardless of whether you feel short of breath.”|
|“Most people find that ipratropium cures their lung disease within a few months.”|
|“You should think of this as an ’emergency drug’, and it should only be used when you experience symptoms.”|
|“It’s important that you perform deep breathing exercises before and after taking ipratropium.”|
A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man’s most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man’s serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?
|The man may be experiencing a paradoxical effect of aspirin|
|The man may be allergic to aspirin|
|The man may be experiencing liver toxicity from the aspirin|
|The man may be experiencing nephrotoxic effects of aspirin|
A patient receives 25 units of NPH insulin at 7.AM. NURS – 6521N Advanced Pharmacology Midterm Exam. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?
A patient is recovering from an acute episode of thrombophlebitis and is being treated with warfarin (Coumadin) 5 mg PO daily. In reviewing medication information, the Nurse Practitioner would include what information in their teaching?
|Maintain close watch on Intake and Output|
|Do not take a multivitamin supplement|
|Limit dairy products|
|Aerobic exercises are the most effective|
A 47-year-old woman has been diagnosed with open-angle glaucoma. Pilocarpine drops are prescribed. The nurse’s assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to
|apply the contact lenses and wait 5 minutes before applying the drops.|
|remove the contact lenses before applying the drops.|
|apply the drops directly on the contact lenses.|
|stop wearing the contact lenses during the pilocarpine therapy. NURS – 6521N Advanced Pharmacology Midterm Exam|
A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his “puffers”. In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to
|permanent liver damage.|
|severe anticholinergic effects.|
A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.
|Is there a need for the drug in treating the presenting problem?|
|Is this the best drug for the presenting problem?|
|Can the patient take the prescribed drug?|
|None of the above.|
A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient’s subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education NURS – 6521N Advanced Pharmacology Midterm Exam. What should the nurse teach the patient about her new medication?
|“By reducing the amount of fluid that your body contains, digoxin will make it easier for your heart to pump.”|
|“This will lessen the workload of your heart by reducing your blood pressure.”|
|“Most patients see their heart failure resolve in 2 to 4 months after they begin taking digoxin.”|
|“This drug won’t cure your disease, but it will help you be able to exercise more and be more comfortable.”|
A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?
|Avoid OTC antacids for the duration of treatment|
|Advocate for intravenous, rather than oral, administration|
|Teach the patient strategies for dealing with headaches|
|Carefully assess the patient for infections|
A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by
|blocking adrenergic receptors and producing antisympathetic effects.|
|inhibiting the movement of calcium ions across the cardiac muscle cell membrane.|
|decreasing sodium and potassium conduction.|
|weakening diastolic depolarization and the action potential duration.|
The APRN would use what class of medication to manage COPD?
|Short-acting and long acting inhaled beta2 agonists|
A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of
|an adrenergic antagonist.|
|an adrenergic agonist.|
The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin. What instructions should be provided to the patient?
|The aspirin is less effective when taken with an antacid so you need to increase the dose.|
|The antacid destroys the aspirin so you should stop taking any antacids|
|The medications should be taken at least 2 hours apart. NURS – 6521N Advanced Pharmacology Midterm Exam|
|There is no effect of the antacid on the aspirin so they can be taken when it is convenient for you|
A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse?
|“Sure, you may take an antacid with ranitidine.”|
|“No, the two drugs will work against each other.”|
|“Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine.”|
|“I wouldn’t advise it. You may experience severe constipation.”|
Mr. Contreras is a 64-year-old patient with Type 2 diabetes. He has recently been diagnosed with hypertension. Which antihypertensive drug is the recommended choice to treat hypertension in patients with diabetes?
|Calcium Channel Blocker|
A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?
|Wash hands before and after taking the medicine|
|Keep track of any gastrointestinal tract infections|
|Monitor glucose levels closely|
|Note the time the medicine is taken each day|
A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is NURS – 6521N Advanced Pharmacology Midterm Exam
A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?
|The amount of the drug that must be given to produce a particular response|
|How well a drug produces its desired effect|
|A drug’s strength of attraction for a receptor site|
|A drug’s ability to stimulate its receptor|
The APRN is seeing Mrs. Smith, age 77, who is here for follow up of hypertension, dyslipidemia, and depression. What should you consider during her follow-up?
|Changes in lean body mass and fluids have little effect on drug serum concentrations|
|No alteration in dosing is required with low albumin levels and protein bound drugs|
|The effects of cardiovascular and CNS medications are predictable in older adults|
|Age-related changes in renal function are the main cause of adverse drug reactions|
The APRN should educate a diabetic patient that beta blockers may mask the signs and symptoms of
NURS – 6521N Advanced Pharmacology Midterm Exam
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