Test 1
A nurse is preparing to administer fentanyl to a patient who has acute pain. Which of the following complications should the nurse monitor for? select all that apply.
A. Urinary retention
B. Tachypnea
C. Constipation
D. Irritating cough
E. Orthostatic hypotensio
A, C, E
Opioids, like fentanyl, can cause urinary retention, constipation, respiratory depression and other CNS effects.
One of your patients is allergic to penicillin. What other class of antibiotics should you use caution with for it has a potential for a cross allergy with penicillins?
A. Macrolides
B. Aminoglycocides
C. Flouroquinolones
D. Cephalosporins
D. Cephalosporins
Cephalosporins run the risk of causing an allergic reaction in those allergic to penicillins.
You just gave one of your patients omeprazole. What is this meds class and what is it classically used for?
Omeprazole is a proton pump inhibitor (PPI) and is used to treat GERD, peptic ulcers, and heartburn.
A patient of yours came to the office for their yearly checkup. They were found to have high LDL and low HDL and were prescribed atorvastatin (Lipitor) to help treat it. What should you teach them about taking this medication? (Select all)
A. Take this medication with an evening meal or at bedtime
B. Rise slowly when getting up from a sitting/lying position
C. Avoid grapefruit or grapefruit juice while taking this
D. Alcohol in moderation is ok to consume while taking this
E. Report any muscle pain or tenderness while taking this
A, C, E
Statins are liver toxic (avoid alcohol, monitor for signs of liver injury), can cause myopathy (muscle pain/tenderness), are taken at night because most cholesterol is synthesized at night, and grapefruit juice should be avoided because it can raise blood levels of statins.
What are some adverse effects of alendronate? (select all)
A. Esophagitits
B. Constipation
C. Jaw pain
D. Muscle tetany/pain
E. Bradycardia
A, C, D
Bisphosphonates, like alendronate, can cause esophogitis/gi ulceration, osteonecrosis of the jaw, low serum calcium (muscle tetany) as well as headaches, visual disturbances, and atypical femur fractures.
When giving a patient phenytoin, what adverse effects should you look out for? Select all that apply.
A. Lethargy
B. Ataxia
C. Nausea
D. Increased seizure activity
E. Gingival hyperplasia
A, B, C, E
This medication is a non-NSAID antiplatelet medication that is used to prevent clots in conditions like afib.
clopidogrel
Things to consider during therapy are to monitor platelet counts, monitor for bleeding, and use caution in those on other anitplatelet/anticoagulant meds.
One of your patients has asthma and was prescribed albuterol and beclomethasone to treat it. What should you tell them about taking these medications if they start to have an asthma attack?
Take the albuterol (short acting beta2 agonist) before taking any other medications.
What are some adverse effects of nitroglycerin to teach your patients about? (select all)
A. Diaphoresis
B. Headache
C. Orthostatic hypotension
D. Constipation
E. Reflex tachycardia
B, C, E
Tell your patients to sit or lie down before taking nitro to avoid falls from hypotension, warn them that headaches are common, their pulse may elevate, and that they can start to form a tolerance to it over time.
A patient of yours was just prescribed levothyroxine to treat hypothyroidism. What is a s/s that they are getting too much and need a dose adjustment?
A. Constipation
B. Cold intolerance
C. Tachycardia
D. Weight gain
C
Levothyroxin is synthetic TH and if a patient gets too much, you can start to see s/s of hyperthyroidism like tachycardia, heat intolerance, weight loss, diarrhea, etc.
A nurse is providing instructions to a patient who has been experiencing anxiety and has a new prescription for diazepam. The nurse should inform the client that which of the following manifestations are adverse effects of diazepam? (Select all that apply.)
A. Incoordination
B. Hypertension
C. Pruritus
D. Sleep driving
E. Amnesia
A, D, E
These vaccines are live vaccines and should be avoided being given to those who are immunocompromised/immunosuppressed. (Select all)
A. MMR
B. Tdap
C. Varicella
D. Influenza (IM form)
E. PCV13
A, C
The live (but weakened) vaccines consist of MMR, Varicella, influenza (nasal), and Zoster
One of your patients is on digoxin to treat their CHF. What S/S should be monitored for in digoxin toxicity? (select all)
A. Fatigue
B. Constipation
C. Anorexia
D. Rash
E. Vision changes
A, C, E
Other signs of digoxin toxicity include N/V, abdominal pain, weakness, bradycardia, and dysrhythmias.
A nurse is preparing to administer potassium chloride IV to a client who has hypokalemia. Which of the following actions should the nurse take? (Select all that apply.)
A. Infuse medication through a large-bore needle.
B. Monitor urine output to ensure at least 20 mL/hr.
C. Administer medication via direct IV bolus.
D. Implement cardiac monitoring.
E. Administer the infusion using an IV pump.
A, D, E
Potassium should NEVER be given in a bolus (can cause cardiac arrest), it ideally should be put through a large bore IV to avoid phlebitis and irritation, it must be given over time through an nfusion, and cardiac monitoring should be implemented to look for signs of hyperkalemia (peaked T-waves).
A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following adverse effects of metformin should the nurse instruct the client to report to the provider?
A. Somnolence
B. Constipation
C. Fluid retention
D. Weight gain
A
Somnolence can indicate lactic acidosis, which is manifested by extreme drowsiness, hyperventilation, and muscle pain. It is a rare but very serious adverse effect caused by metformin and should be reported to the provider.
What is a prototype drug?
A. The newest drug in a certain class
B. The coolest drug in a class
C. The most used drug in a certain class
D. Usually the first drug in a class of drugs that other drugs in that class are made from
D
You just gave one of your patients epoetin alfa to treat her anemia caused by chronic kidney disease. What symptom of increasing BP should you monitor for?
A. Abdominal pain
B. Headaches
C. Pedal pulses of +2
D. Swelling of the hands and feet
B.
Epoetin alfa can cause a dangerous rise in BP and headaches are a tell tale sign of high BP.
This drug is one of the most popular general anesthetics to use and it must be used w/ in 6 hours if opening the vial due to risk of bacterial growth.
Propofol
Propofol is a milky, fat-based substance that can induce and maintain general anesthesia very quickly and easily.
A nurse is caring for a client who has increased liver enzymes and is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?
A. Glucosamine
B. Saw palmetto
C. Kava
D. St. John’s wort
C
Kava can cause liver injury and should be avoided in those who have or are suspected of having liver damage/disease.
What are some s/s of hypocalcemia? (select all)
A. numbness and tingling of the lips, fingers, and toes
B. Constipation
C. Muscle spasms
D. Positive Chvostek's sign
E. Drowsiness
A, C, D
Hypocalcemia (<8.5 mg/dl) can also cause facial twitching, larygospasms, seizures, and a positive, Trousseau's sign
One of your patients was just diagnosed with Alzheimer's and was given a prescription for Donepezil. What education would you provide them about Donepezil? Select all that apply.
A. Take this drug at bedtime every night
B. Take this drug with food
C. Stop taking this drug once your memory starts to improve
D. You will need to get periodic blood tests done to check blood levels of this drug
A, B, D
This drug is taken at bedtime, it can cause GI upset so take with food/glass of water, blood levels are checked for therapeutic levels.
This the therapy of choice to treat HIV infection and the goal is to quickly reduce the viral load and keep it low for as long as possible.
HAART
Highly active antiretroviral therapy and this is done with a combination of antiretrovirals.
One of your patients is on lisinopril and forms a chronic cough. What medication would you switch them to in order to relieve this?
A. Nifedipine
B. Metoprolol
C. Furosemide
D. Losartan
D.
lisinopril is an ACE inhibitor and can cause a chronic, nagging cough. If this happens, you can switch them to an ARB, like losarton, that works just the same as an ACE but without the cough.
This supplement is given to treat pernicious anemia and it needs to be given IM or intranasaly for those who lack intrinsic factor in their gut.
Vitamin B12
One of your patients is on glipizide. How does this medication work to lower blood glucose?
A. Makes cells less resistant to insulin
B. Reduces the release of glucagon from the pancreas and reduced glycogenolysis in the liver
C. Slows the digestion of glucose postprandial
D. Increases the amount of insulin the pancreas produces
D.
Sulfonylureas (like glipizide) cause the pancreas to release more insulin.