Basic principles & PNS
Cardiac
Infectious disease
Asthma, cold, allergy
Pain, anti-inflammatories, arthritis and gout
100
When administering oral medications to a client, the nurse recognizes that some drugs might be completely metabolized by the liver circulation before entering general circulation. This is known as _______.
What is the first pass effect?
100
1. Heparin sodium is prescribed for the client. The nurse expects that the health care provider will prescribe which of the following to monitor for a therapeutic effect of the medication? 1. Hematocrit level 2. Hemoglobin level 3. Prothrombin time (PT) 4. Activated partial thromboplastin time (aPTT)
What is 4. aPTT
100
The development of a new infection as a result of the elimination of normal flora by an antibiotic is referred to as what? A. Resistant infection B. Superinfection C. Nosocomial infection D. Allergic reaction
What is B Superinfection?
100
A patient is admitted to the emergency department with acute severe exacerbation of asthma. Which drug should the nurse anticipate will be included in the treatment plan? A. Oral theophylline (Elixophyllin) B. Subcutaneous omalizumab (Xolair) C. Inhaled mometasone furoate (Asmanex) D. High-dose albuterol (Proventil) via nebulizer treatment
What is D. High-dose albuterol (Proventil) via nebulizer treatment
100
1. Name the main disadvantage of Ester-type local anesthetics such as Procaine? A. Effects last longer than needed due to slow metabolism by circulating esterases B. Serious allergic reactions are more common in ester-type, than in amide-type, local anesthetics C. They must be given topically D. They are prohibitively expensive
What is B. Serious allergic reactions are more common than in amide-type anesthetics Ester-type local anesthetics such as Procaine are metabolized QUICKLY by circulating esterases, and anesthetics cannot be delivered topically. Today amide-type anesthetics are used because they do not have the same danger of allergic reaction as the older ester-type anesthetics.
200
5. The nurse is administering isoproterenol, a beta1 and beta2 agonist. The nurse expects the patient to show which effects of this drug? (Select all that apply.) A. Increased heart rate B. Excessive drowsiness C. Increased force of heart contraction D. Decreased cardiac output E. Bronchial dilation F. Decreased glucose levels
What is A. increased heart rate, C. increased force of heart contraction, and E. Bronchial dilation?
200
A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol? 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes 3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication 4. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication
What is 2. the development of auditory wheezes?
200
A patient is receiving vancomycin (Vancocin). The nurse identifies what as the most common toxic effect of vancomycin therapy? A. Ototoxicity B. Hepatotoxicity C. Renal toxicity D. Cardiac toxicity
What is C. Renal toxicity?
200
Which instruction should be included in the teaching for a patient for whom fluticasone propionate (Flovent) MDI has been ordered? A. "Gargle after using your inhaler." B. "Take the medication immediately at the onset of an attack." C. "Take your albuterol first, followed by the Flovent 5 minutes later." D. "Make sure you monitor your fingerstick blood glucose level each morning."
What is A. gargle after using your inhaler?
200
2. What adverse CNS effects can occur when too much local anesthetic creates systemic toxicity?
They cause CNS excitation (including seizures) followed by depression (including drowsiness, unconsciousness, coma, & death)
300
A nurse prepares to administer a new prescription for bethanechol (Urecholine). Which information in the patient's history should prompt the nurse to consult with the prescriber before giving the drug? a. Asthma as a child b. Gastroesophageal reflux c. Hypertension d. Hypothyroidism
What is asthma as a child?
300
5. The client has been receiving spironolactone (Aldactone) 50 mg/day for heart failure. The nurse should closely monitor the client for which condition? a. Hypokalemia b. Hyperkalemia c. Hypoglycemia d. Hypermagnesemia
What is b. Hyperkalemia
300
Which instructions will the nurse include when teaching a patient about cephalosporin therapy? (Select all that apply.) A. "Notify your healthcare provider if you develop diarrhea." B. "Take aspirin if you develop a headache." C. "Notify your healthcare provider if you develop a rash." D. "Cephalosporins may not be taken with food." E. "Do not take cephalosporins if you have lactose intolerance."
What is A. "Notify your healthcare provider if you develop diarrhea." and C. "Notify your healthcare provider if you develop a rash." ?
300
A nurse is teaching a patient who is to start taking an expectorant. The nurse provides the patient with which of these instructions? A. "Restrict cold fluids to promote reduced mucus production." B. "Take the medication once a day only, usually at bedtime." C. "Increase your fluid intake to reduce the viscosity of secretions." D. "Increase your fiber and fluid intake to prevent constipation."
What is C. "Increase your fluid intake to reduce the viscosity of secretions."?
300
3. Select all options that are true about opioid analgesics A. They interact with mu receptors, sometimes with kappa receptors, but never with delta receptors B. They are the most effective drugs in controlling pain without causing unconsciousness C. They do not have a significant abuse potential D. There most serious adverse effect is respiratory depression
What is A, B, and D. Opioid medications generally do carry a risk for abuse
400
9Many medications list side effects that include dry mouth, constipation, and urinary retention. What kind of effects are these? a. Alpha adrenergic b. Anticholinergic c. Beta adrenergic d. Sympathetic
What is B. Anticholinergic?
400
7. The client is prescribed captopril (Capoten) for treatment of HF. The nurse teaches that the primary action of the drug is to a. Prevent influx of calcium. b. Lower peripheral resistance and reduce blood volume. c. Increase strength of ventricular contractions. d. Increase heart rate.
What is b. lower peripheral resistance and reduce blood volume.
400
Which instruction should a nurse include in the discharge teaching for a patient who is to start taking tetracycline (Sumycin)? A. "You may stop taking the pills when you begin to feel better." B. "Use sunscreen and protective clothing when outdoors." C. "You'll have to come back to the clinic for weekly blood work." D. "Take the medication with yogurt or milk so you won't have nausea."
What is B. Use sunscreen and protective clothing when outdoors?
400
Which statement by a patient indicates understanding of a nurse's teaching about fluticasone nasal spray (Flonase)? A. "I'll gradually stop taking this so I don't have any problems with withdrawal." B. "This drug will help prevent the inflammation and irritation from my allergies." C. "I'll have to be more careful about not falling, because my bones may break more easily." D. "I realize that I only need to take this when my symptoms are really bad."
What is B. "This drug will help prevent the inflammation and irritation from my allergies."?
400
4. Select all that apply concerning the drug….Aspirin A. Causes reversible inhibition of cyclooxygenase B. Provides relief of mild to moderate pain C. Reduces fever D. Is anti-inflammatory E. Remains a drug often used to treat osteoarthritis and rheumatoid arthritis F. Can cause serious toxicity
What is B, C, D, E, and F……Causes irreversible inhibition of cyclooxygenase. Cells need to make new receptors to replace those bound by aspirin. Platelets lack the ability to regenerate their receptors, so aspirin inhibits the platelets aggregation ability for the remainder of the platelets life (about 8 days)
500
A nurse is teaching a group of nursing students about neuromuscular blocking agents. For what may these agents be used? (Select all that apply.) a. Analgesia b. Electroshock therapy (ECT) c. Malignant hyperthermia d. Mechanical ventilation e. Surgery
What is B. ECT, D. Mechanical ventilation, and E. Surgery
500
A nurse is caring for a client who has been prescribed furosemide (Lasix) and is monitoring for adverse effects associated with this medication. Which of the following should the nurse recognize as a potential adverse effect. Select all that apply. 1. Nausea 2. Tinnitus 3. Hypotension 4. Hypokalemia 5. Photosensitivity 6. Increased urinary frequency
What is : 2. Tinnitus, 3. Hypotension, 4. Hypokalemia?
500
Which cardiovascular finding does the nurse identify as a possible adverse effect of erythromycin (Ery-Tab) therapy? A. Heart rate of 52 beats per minute B. Prolonged QT interval C. Jugular vein distention D. Grade III diastolic murmur
What is B. Prolonged QT interval?
500
Which instruction by the nurse should be the priority for a patient scheduled to start intranasal cromolyn (NasalCrom)? A. "It is only moderately effective." B. "There are few adverse reactions." C. "Relief may take a week or two." D. "It suppresses histamine release."
What is C. "Relief may take a week or two."?
500
5. Three part question…. A. what is the class of medications as a first line therapy for an initial attack of gout? B. What is the class of drug used as the second line of medications in cases the first line is either not sufficient or contraindicated? C. What type of drug (or an example) is given longer term to those with frequent attacks in order to lower the uric acid levels in their blood?
What is A. NSAIDS, B. Glucocorticoids, and C. Urate-lowering Therapy (allopurinol)
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