Week 4
Which of the following is NOT a serious adverse effect of long-term oral glucocorticoid therapy?
A. Adrenal suppression
B. Osteoporosis
C. Hyperglycemia
D. Gastroesophageal reflux disease
D. GERD
Can cause all the above plus peptic ulcer disease
A nurse is taking care of a patient undergoing diuresis. The nurse is reviewing the patients labs and notes that the GFR is significantly reduced. Which diuretic class would the nurse expect the provider to order?
A. thiazide
B. loop
C. potassium-sparing
D. osmotic
B. loop diuretic such as furosemide
A nurse is about to administer a scheduled dose of simvastatin to a client. Which of the following findings would make the nurse hold the dose and contact the provider?
A. severe diarrhea
B. upper abdominal pain
C. muscle pain
D. green urine
C. Signs of myopathy and rhabdomyolysis
Upper abdominal pain could be a sign of gallstones, adverse effect of gemfibrozil.
Green urine could be caused by medications like promethazine indomethacin
Statins often cause constipation
The nurse recognizes which of the following antihistamines is the most likely to cause sedation in a client?
A. chlorpheniramine
B. levocetirizine
C. olopatadine
D. loratadine
A. This is a first generation along with diphenhydramine. The remain drugs are examples of second- generation antihistamines.
The nurse is providing education to a client who has been started on verapamil. The explains that this drug is generally well tolerated, but the most common complaint is?
A. nausea
B. confusion
C. sexual dysfunction
D. constipation
D
The nurse is educating a client that which of the following drug classes is the most effective for relieving acute bronchospasm
A. Inhaled budesonide
B. Inhaled levalbuterol
C. Inhaled arformoterol
D. Inhaled ipratropium
B.
Inhaled short-acting inhaled beta2 agonists (SABAs) are the most effective drugs for relieving acute bronchospasm and preventing exercise-induced bronchospasm
The nurse knows that which class of calcium channel blocker acts primarily on the arterioles.
A. dihydropyridines
B. trihydropyridines
C. monohydropyridines
D. nondihydropyridines
A.
Which of the following drugs prevents the pain of stable angina primarily by reducing the heart rate and contractility, which reduces the cardiac oxygen demand?
A. nitroglycerin
B. ranolazine
C. metoprolol
D. nifedipine
C. Beta blockers prevent the pain of stable angina primarily by reducing the heart rate and contractility, which reduces the cardiac oxygen demand.
The nurse knows that potassium sparing diuretics should not be combined with which of the following?
A. angiotensin-converting enzyme inhibitors
B. potassium supplements
C. angiotensin-receptor blockers
D. Direct renin inhibitors
B. Because of the risk of hyperkalemia, potassium-sparing diuretics should not be combined with one another or with potassium supplements, and they should be used cautiously in patients taking angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, or direct renin inhibitors.
The nurse knows that what drug is used to treat severe heparin-induced bleeding?
Severe heparin-induced bleeding can be treated with protamine sulfate, a drug that binds heparin, stopping it from working
The nurse knows that which of the following is the first-line drugs for for mild to moderate allergic rhinitis?
A. Glucocorticoids
B. Antihistamines
C. Anticholinergics
D. Sympathomimetics
B.
Antihistamines (H1-receptor antagonists) are first-line drugs for allergic rhinitis. They relieve rhinorrhea, sneezing, and itching but not congestion.
A nurse is providing education to a patient who has hypertension about how his new medication, propranolol primarily works to lower his blood pressure.
A. reduce blood volume
B. reducing peripheral vascular resistance
C. preventing retention of sodium and water in the kidneys
D. reducing myocardial contractility
B. Beta blockers (e.g., propranolol) appear to lower BP primarily by reducing peripheral vascular resistance. They may also lower BP by reducing myocardial contractility and suppressing reflex tachycardia (through beta1 blockade in the heart) and by reducing renin release (through beta1 blockade in the kidneys).
The nurse is taking care of a patient who has been started on warfarin. The nurse expects the provider to place what lab order to monitor this medications.
A. fibrinogen level
B. prothrombin time
C. platelet level
D. partial thromboplastin time
Warfarin therapy is monitored by measuring the prothrombin time (PT). The results are expressed as the international normalized ratio (INR). An INR of 2 to 3 is the target for most patients.
Heparin therapy is monitored by measuring the activated partial thromboplastin time (aPTT). The target aPTT is 60 to 80
The nurse knows that ACE inhibitors are contraindicated in all the following conditions except?
A. third trimester of pregnancy
B. bilateral renal artery stenosis
C. history of angioedema reaction
D. chronic kidney disease
D.
Which of the following drugs belongs to the class of medications that is the most effective for the prevention and treatment of seasonal an perennial rhinitis?
A. propionate
B. azelastine
C. diphenhydramine
D. ipratropium
A. Inhaled glucocorticoids (flonase)
The nurse is taking care of a 26 week old pregnant female with peptic ulcer disease. The nurse would question which of the following orders written by the provider?
A. cimetidine
B. omeprazole
C. sucralfate
D. misoprostol
D. Misoprostol stimulates uterine contraction and therefore is contraindicated during pregnancy.
Which of the following drugs is known to slow progression of HF and prolong survival in patients with HF?
A. beta blockers
B. diuretics
C. cardiac glycosides
D. ace inhibitors
Beta blockers can prolong survival in patients with HF and therefore are considered first-line therapy.
The principal cause of vitamin B12 deficiency is impaired absorption from?
The principal cause of vitamin B12 deficiency is impaired absorption secondary to lack of intrinsic factor.
A nurse is about to administer a scheduled dose of lovastatin to a client. Which of the following lab findings would make the nurse contact the provider to report a concern for complications related to the medication?
A. elevated low-density lipoprotein (LDL)
B. elevated blood sugar
C. elevated fibrinogen
D. elevated creatinine kinase
D. CK an enzyme released from injured muscles sign of rhabdomyolysis
The nurse is taking care of a client that is taking spironolactone and enalapril. The nurse will monitor for which of the following primary adverse effect?
A. hyperuricemia
B. hypermagnesemia
C. hyperkalemia
D. Hypercalcemia
C. Because of the risk of hyperkalemia, potassium-sparing diuretics should not be combined with one another or with potassium supplements, and they should be used cautiously in patients taking angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, or direct renin inhibitors.
The nurse knows that they should administer bulk-forming laxatives with fluids to prevent?
A. small bowel obstruction
B. fecal impaction
C. esophageal obstruction
D. constipation
c. esophageal obstruction
The nurse knows that Amiodarone (a class III agent) is highly effective against atrial and ventricular dysrhythmias but can cause multiple serious adverse effects, including damage to which of the following? (select all that apply)
A. lungs
B. thyroid
C. pancreas
D. eyes
A, B, C Amiodarone (a class III agent) is highly effective against atrial and ventricular dysrhythmias but can cause multiple serious adverse effects, including damage to the lungs, eyes, liver, and thyroid.
To prevent neural tube defects, all patients who may become pregnant should ingest___-____ of folate daily in addition to the folate they get in food.
400 to 800 mcg of folate daily in addition to the folate they get in food.
The student nurse knows that (which drug) is a derivative of amiodarone and is somewhat else toxic than amiodarone but also less effective?
Dronedarone, a derivative of amiodarone, is somewhat less toxic than amiodarone but also less effective.
Which part of the patient’s history would cause the nurse to withhold a dose of ondansetron?
a. type II diabetic
b. allergy to shellfish
c. long QT syndrome
d. history of childhood asthma
C. long QT syndrome. Risk for torsades de pointes