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Pharmacology

A comprehensive study of drugs and their effects on living systems, including the mechanisms of action, therapeutic uses, adverse effects, and interactions.

drugs

medications

pharmacokinetics

pharmacodynamics

drug interactions

pharmacogenetics

pharmacovigilance

adverse drug reactions

therapeutic drug monitoring

drug therapy

drug dosage

drug metabolism

practical nursing

The dosage of a benzodiazepine should be tapered gradually over:

  • 6 to 8 days
  • 2 to 6 weeks
  • 6 to 8 weeks
  • 1 to 2 weeks

Requiring increase dose to achieve therapeutic effect.

  • Drug tolerance
  • Drug habituation
  • Side effect
  • Idiosyncratic effect

Pneumococcal conjugate vaccine (PCV) is given orally.

  • False

Monitor for neurotoxicity with vincristine sulfate manifested as:

  • anorexia, nausea and vomiting and stomatitis
  • numbness and tingling in the fingers and toes
  • hoarseness
  • hyperuricemia

For clients receiving tricyclic medications should be instructed to avoid alcohol and nonprescription medications.

  • To prevent adverse medication interactions.

Circadian and sleep cycles can also affect drug therapy.

  • True

When administering phenytoin intravenously, infuse no faster than 25 to 50 mg/min; otherwise, hypertension and cardiac dysrhythmias could occur.

  • false

12. Type of metabolites that does not have pharmacologic action.

  • Passive metabolite
  • Nonactive metabolite
  • Active metabolite
  • Inactive metabolite

Topical eye anesthetics are used for anesthesia for eye examinations and surgery or to keep foreign bodies from the eye.

  • False

Adrenergic agonist is contraindicated in clients with:

  • Hypotension
  • Myasthenia gravis
  • Relieving symptoms of Parkinson’s disease
  • Angle-closure glaucoma

Monitor for petechiae, ecchymosis, bleeding of the gums, and nosebleeds.

  • Because the decreased platelet count can precipitate bleeding tendencies.

If diarrhea is a problem, avoid hot foods and high-fiber foods.

  • Because these increases peristalsis.

The nurse should advise the client taking cholinergic medication to take the medication as prescribe.

  • Because cholinergic medications can cause bronchospasms and increased bronchial secretions.

Benzodiazepines interact with other CNS medications, producing an additive effect. TRUE

  • False

Thrombolytic medication is contraindicated in clients with active internal bleeding.

  • True

Antihistamine is used for colds and rhinitis.

  • True

Streptokinase

  • Aminocaproic acid (Amicar)

Antidiuretic hormones enhances reabsorption of water in the kidneys.

  • True

Antigout medication should be used cautiously in clients with gastrointestinal disease.

  • True

Which of the following is not used to decrease extrapyramidal side effects:

  • Clonazepam (Klonopin)
  • Diazepam (Valium)
  • Amantadine (Symmetrel)
  • Benztropine (Cogentin)

Rectal route is considered topical application.

  • True

11. Type of metabolites that has a pharmacologic action.

  • Active metabolite
  • Inactive metabolite
  • Nonactive metabolite
  • Passive metabolite

Antacids is used in clients with peptic ulcer disease and gastroesophageal reflux disease.

  • True

1 1/2 TO 3 1/2 8.

  • Pneumococcal conjugate vaccine

Client’s positive and negative expectations can increase or decrease response of the drug.

  • True

Client receiving antineoplastic medication should initiate bleeding precautions if:

  • the client develops nephrotoxicity
  • thrombocytopenia occurs
  • the client develops anaphylactic reaction
  • neutropenia occurs

5. A scientist that researches new drugs.

  • Pharmacy technician
  • Pharmacologist
  • Pharmacist
  • Clinical pharmacist

Clients taking anticoagulants should not take aspirin or NSAIDS.

  • TRUE

3. Tocolytics is used for:

  • Preventing and controlling seizures in preeclamptic and eclamptic clients
  • Used to relieve moderate to severe pain associated with labor
  • Stimulate uterine contractions
  • To halt uterine contractions and prevent preterm birth.

When administering levodopa, instruct the client to avoid excessive vitamin B12 intake.

  • false

A concentrated form of a drug made from vegetables or animals.

  • Tincture
  • Aqueous suspension
  • Extract
  • Syrup

Vaccines administered intramuscularly in infants are best given in:

  • dorsogluteal muscle
  • deltoid muscle
  • vastus lateralis muscle
  • lateral upper arms

The nurse should instruct the client not to use sodium osmotic with older adults or children.

  • Because it may cause fluid and electrolyte imbalances.

A flat, round, or oval preparation that dissolves and releases a drug when held in the mouth.

  • Lozenge
  • Capsule
  • Caplet
  • Elixir

Antithyroid medication is used for hyperthyroidism or Grave’s disease.

  • True

Edrophonium (Tensilon)

  • Atropine sulfate

Aluminum hydroxide is used to treat hypophosphatemia.

  • False

Opioids analgesics is used for:

  • To halt uterine contractions and prevent preterm birth.
  • Preventing and controlling seizures in preeclamptic and eclamptic clients
  • Stimulate uterine contractions
  • Used to relieve moderate to severe pain associated with labor

If the client receiving immunosuppressants, flowers, plants, fresh fruit, and raw vegetables should be discouraged.

  • Because of infection risk.

Before administering a bolus, the nurse should look up the maximum concentration recommended for the particular drug.

  • True

Which of the following is not correct in magnesium sulfate?

  • Relaxes smooth muscle, including the uterus
  • Used for preeclamptic clients to prevent seizures
  • Central nervous system depressant
  • Calcium channel blocker

Immunomodulators stimulates the immune system to recognize cancer cells and take action to eliminate or destroy them.

  • True

Hypersensitive, life-threatening reaction.

  • Drug interaction
  • Drug abuse
  • Anaphylactic reaction
  • Reason medication was prescribed

Diazepam (Valium) acts on the CNS to suppress spasticity and affect skeletal muscle directly.

  • False

Nitrofurantoin is contraindicated in clients with renal impairment.

  • True

Hepatotoxic medications are avoided with the use of androgens.

  • Because of the risk of additive damage to the liver.

Which of the following is not a positive symptom of schizophrenia:

  • delusions
  • hallucinations
  • avolition
  • aggression

Pneumococcal conjugate vaccine (PCV) administration route is:

  • Oral route
  • Intradermal route
  • Subcutaneous route
  • Intramuscular route

21. Injected in tissue just below skin.

  • Intramuscular route
  • Subcutaneous route
  • Intravenous route
  • Parenteral route

Mexiletine may be administered with food or antacids.

  • To reduce gastrointestinal distress.

Which of the following is not a rapid acting insulin:

  • NovoLog
  • Apidra
  • Humalog
  • NovoLog Mix 70/30

The main side effect of thrombolytic medication is formation of thrombus.

  • False

Parasympatholytic medication is used in children and clients with narrow-angle glaucoma.

  • False

Prostaglandin is administered orally to induce labor.

  • False

Medication used to treat psoriasis that is contraindicated during pregnancy.

  • Cyclosporine (Neoral)
  • Alefacept (Amevive)
  • Methotrexate
  • Acitretin (Soriatane)

When doing subcutaneous injection, the nurse should use z-track technique to avoid injecting the blood vessels.

  • False

Neuromuscular blockers

  • Anticholinesterase drugs

Skeletal muscle relaxant is indicated for clients with cerebral palsy.

  • True

Cures a disease or condition.

  • Palliative
  • Substitutive
  • Supportive
  • Curative

22. An aerosol generator that converts liquid drug solutions or suspensions into aerosol and is powered by compressed air, oxygen, a compressor, or an electrically powered device.

  • Metered-dose inhaler (MDI)
  • Inhalation
  • Nonpressurized aerosol (nebulizer) (NPA)
  • Dry powdered inhaler (DPI)

Varicella vaccine administration route is:

  • Subcutaneous route
  • Intradermal route
  • Intramuscular route
  • Oral route

1. Order: Client is receiving Erythromycin 750 mg, the stock on hand is 250 mg in 5 mL. How many ML should be given. (5 POINTS)

  • 15 mL

Instruct the client about the need for contraception.

  • Because these medications have teratogenic effects.

4. It is the metabolic conversion of drug molecules to more water-soluble metabolites or less active form that are more readily excreted.

  • Biotransformation

Oder people who are taking sedatives require higher dosage due to decrease absorption of the drugs.

  • False

Positive inotropic and cardiotonic medications are used for:

  • Intravenous administration
  • Intramuscular administration
  • Oral tablet
  • Subcutaneous administration

25. Which of the following is nonbenzodiazepine anxiolytic:

  • Buspirone (BuSpar)
  • Chlordiazepoxide (Librium)
  • Flumazenil (Romazicon)
  • Clorazepate (Tranxene)

Inappropriate intake of a medication.

  • Drug abuse
  • Reason medication was prescribed
  • Drug interaction
  • Anaphylactic reaction

19. Which of the following is an indication of anticholinergic medication.

  • Myasthenia gravis
  • Hypotension
  • Angle-closure glaucoma
  • Relieving symptoms of Parkinson’s disease

Furosemide (Lasix) is a:

  • Thiazide and thiazide-like diuretics
  • Potassium-sparing diuretics
  • Osmotic diuretics
  • Loop diuretics

In inserting rectal suppositories, the nurse should assist the client to a left lateral or left Sims’ position, with the upper leg flexed.

  • True

Magnesium sulfate

  • Calcium gluconate

An antineoplastic medication that affect cells in any phase of the reproductive cycle.

  • Cell cycle phase1–specific medications
  • Cell cycle phase–specific medications
  • Cell cycle phase–nonspecific medications
  • Cell cycle phase1–nonspecific medications

Cardiac glycosides

  • Lanoxicaps

Ergot alkaloids is contraindicated in clients with the following except:

  • hypertension
  • cardiovascular disease
  • postpartum hemorrhage
  • peripheral vascular disease

Which immunomodulator slows tumor cell division?

  • Immunomodulators
  • Interferons
  • Interleukins
  • Colony-stimulating factors

Give the rationale of the following nursing intervention for clients receiving medications for musculoskeletal system. 2 points each.

  • Because the adverse effect is liver damage and gastrointestinal bleeding.
  • Clients receiving antigout medication should be cautioned not to take aspirin.
  • BECAUSE THIS COULD TRIGGER A GOUT ATTACK.
  • Answer 2
  • To prevent kidney stones.
  • (WRONG)
  • Bisphosphonates must be administered in the morning before eating or drinking with a full glass of water.
  • Answer 3
  • Because of the risk of esophagitis.
  • Monitor liver function tests when a client is taking a skeletal muscle relaxant.
  • Answer 4
  • Because hepatotoxicity can occur.
  • Clients receiving antigout medication should maintain fluid intake of at least 2000 to 3000
  • mL/day.
  • Answer 5
  • You have correctly selected 3.

Client taking prednisone should monitor glucose and serum potassium levels because it can cause hyperglycemia and hypokalemia.

  • True

Thiazide and thiazide-like diuretics should be used with caution in client:

  • with hypertension
  • taking lithium
  • with peripheral edema
  • taking potassium supplements

The client receiving a laxative need to increase fluid intake.

  • To prevent dehydration.

Which of the following is not a typical cholinergic effect:

  • constipation
  • sweating
  • papillary constriction
  • diarrhea

______________4. Keratolytics suppresses DNA synthesis, miotic activity, and cell proliferation.

  • True
  • False

Tamoxifen citrate may cause impotence and gynecomastia in men.

  • False

Instruct the client that cyclophosphamide, when prescribed orally, is:

  • administered at night
  • administered with food
  • administered without food
  • administered in the morning

Offer sips of water before giving sublingual nitrates:

  • so that the drug will be dissolve in the stomach
  • to decrease production of saliva
  • to swallow the drug easily
  • because dryness may inhibit medication absorption

4. Specialist who often guides the primary care provider in prescribing drugs.

  • Pharmacist
  • Clinical pharmacist
  • Pharmacologist
  • Pharmacy technician

Obtain a drug history before the administration of an opioid analgesic.

  • Some medications may be contraindicated if the client has a history of opioid dependency because these medications can precipitate withdrawal symptoms in the client and newborn.

2. The name under which a drug is listed in one of the official publications.

  • Generic name
  • Official name
  • Trade name
  • Chemical name

An example of beta adrenergic blockers.

  • Prazosin (Minipress)
  • Nitroglycerin
  • b. Propranolol (Inderal)
  • Amlodipine (Norvasc)

Prolonged use of antibiotics can increase the client’s risk of superinfections, or secondary infections.

  • True

Which of the following symptoms of anaphylactic reaction due to antineoplastic medications.

  • Increased sensorium
  • Diarrhea
  • Hypertension
  • Dyspnea

RhoGAM should be administered within 72 hours before potential or actual exposure to Rh-positive blood.

  • False

When a drug is absorbed from the GI tract, it enters the portal circulation before entering the systemic circulation.

  • First-pass metabolism

The client receiving antineoplastic medication is instructed to use a soft toothbrush and electric razor to:

  • to prevent infection
  • to prevent neutropenia
  • to prevent developing Reye’s syndrome
  • to minimize the risk of bleeding

Take anticonvulsants with food or milk but avoid alcohol.

  • false

Methenamine is recommended for acute urinary tract infection.

  • False

Tincture of opium can be diluted with 15 to 30 mL of water for administration.

  • To lessen unpleasant taste.

Clients receiving antiemetic should protect from injury.

  • Antiemetics can cause drowsiness.

______________7. Client who use Aminolevulinic acid (Levulan Kerastick) should protect the area from sunlight and bright indoor lights.

  • True
  • False

Fluorouracil (Adrucil) may cause alopecia, stomatitis, diarrhea, phototoxicity reactions, and cerebellar dysfunction.

  • True

Prostaglandin is used for:

  • To halt uterine contractions and prevent preterm birth.
  • Used to relieve moderate to severe pain associated with labor
  • Stimulate uterine contractions
  • Preventing and controlling seizures in preeclamptic and eclamptic clients

Phenytoin (Dilantin) is used to treat partial and generalized tonic-clonic seizures.

  • TRUE

Cardiac glycosides produce a positive inotropic action, which:

  • Increase the force of myocardial contractions
  • Slows the heart rate
  • Decreases the force of myocardial contractions
  • Increases the heart rate

Cholinergic drug include Bethanechol chloride (Urecholine).

  • True

Give the rationale of the following nursing intervention for clients receiving medications for urinary system. 2 points each.

  • Because of the side effects of dizziness and drowsiness.
  • Dosage of cinoxacin (Cinobac) should be reduced in clients with renal impairment.
  • Answer 2
  • Because it could result in accumulation of the medication to toxic levels.
  • Intravenously administered ciprofloxacin and ofloxacin are infused slowly over 60 minutes.
  • Answer 3
  • To minimize discomfort and vein irritation.
  • Methenamine (Mandelamine, Hiprex, Urex) should not be combined with sulfonamides.
  • Answer 4
  • Because of the risk of crystalluria and urinary tract injury.
  • Nalidixic acid (NegGram) should not be administered to children younger than 3 months.
  • __________________________________________________________________________
  • Answer 5
  • Because this may produce intracranial hypertension in pediatric clients.

BIRTH 2.

  • BCG

______________2. Acneiform eruptions is included also in systemic adverse effects of topical glucocorticoids.

  • True
  • False

The side effects of antineoplastic medication results from its effects in cancer cells.

  • False

Which of the following damages HIV’s DNA interfering with ability control host DNA?

  • Non-nucleoside reverse transcriptase inhibitors
  • Fusion inhibitors
  • Nucleoside-nucleotide reverse transcriptase inhibitors
  • Protease inhibitors

Tocolytics produce uterine relaxation and suppress uterine activity.

  • True

Leukotriene modifiers are contraindicated in breast feeding mothers.

  • True

An antineoplastic medication that affect cells only during a certain phase of the reproductive cycle.

  • Cell cycle phase–nonspecific medications
  • Cell cycle phase–specific medications
  • Cell cycle phase1–nonspecific medications
  • Cell cycle phase1–specific medications

Typical antipsychotic medication is given in clients exhibiting alogia.

  • FALSE

Magnesium sulfate is used with caution in clients with:

  • myocardial damage
  • heart block
  • renal failure
  • severe renal impairment

Antitussives should not be administered to the client with a head injury or a postoperative cranial surgery client.

  • True

Digoxin (Lanoxicaps, Lanoxin) is contraindicated in clients with:

  • Ventricular dysrhythmias
  • Hypokalemia
  • Hypothyroidism
  • Renal disease

Bethanechol chloride (Urecholine) is not given to a client who has a urinary stricture or obstruction.

  • True

Topical glucocorticoids cannot be absorbed into the systemic circulation.

  • False

Enoxaparin

  • Protamine sulfate

19. These routes have the highest bioavailability and not subject to first-pass metabolism or harsh GI environment.

  • Intramuscular route
  • Intravenous route
  • Parenteral route
  • Subcutaneous route

Anticoagulant is contraindication in clients with myocardial infarction and deep vein thrombosis.

  • False

Antitumor antibiotic medication, dysrhythmias can occur with:

  • Doxorubicin (Adriamycin, Doxil) and idarubicin (Idamycin)
  • Daunorubicin (DaunoXome)
  • bleomycin (Blenoxane)
  • All of the above

9 MONTHS TO 1 YEAR 9.

  • Measles, mumps and rubella (MMR)

The nurse should advise the client taking anticholinergic medication that antacid:

  • should be taken with these medications
  • should be taken with food
  • decreases the absorption of these medications
  • increases the absorption of these medications

Medication used to treat psoriasis that is contraindicated in clients with human immunodeficiency virus infection.

  • Cyclosporine (Neoral)
  • Acitretin (Soriatane)
  • Alefacept (Amevive)
  • Methotrexate

1 1/2 TO 3/12 MONTH 6.

  • Oral polio vaccine (OPV)

Which of the following blood levels that needs to be monitored if the client is receiving Warfarin sodium (Coumadin):

  • Platelet count
  • Prothrombin time (PT)
  • Activated partial thromboplastin time (aPTT)
  • Hematocrit

3. This name describes the constituents of the drug precisely.

  • Official name
  • Generic name
  • Trade name
  • Chemical name

Montelukast, oral (Singulair) should be taken 1 hour before or 2 hours after meal.

  • True

An aqueous solution of sugar often used to disguise unpleasant-tasting drugs.

  • Extract
  • Syrup
  • Tincture
  • Aqueous suspension

Sodium bicarbonate may cause milk-alkali syndrome.

  • False

Magnesium sulfate is used for:

  • To halt uterine contractions and prevent preterm birth.
  • Preventing and controlling seizures in preeclamptic and eclamptic clients
  • Used to relieve moderate to severe pain associated with labor
  • Stimulate uterine contractions

Instruct clients with diabetes mellitus using β-adrenergic blockers as an eye medication to monitor blood glucose levels frequently.

  • TRUE

Client taking anticholinergic has drug interaction in the following except:

  • tricyclic antidepressants
  • phentolamine
  • phenothiazines
  • antihistamines

During the administration of positive inotropic and cardiotonic medications, the nurse should:

  • Monitor for edema.
  • Advise the client to eat foods high in potassium.
  • Place the client on continuous electrocardiographic monitoring.
  • Teach the client the signs and symptoms of toxicity.

The onset of drug action in transdermal route is slower than oral route.

  • False

Which of the following is not a short acting insulin:

  • Humulin R
  • Humulin 50/50
  • Novolin R
  • Humulin R (U 500)

Which of the following is not a withdrawal symptom of benzodiazepine:

  • Sweating
  • Vomiting
  • Hypotension
  • Insomnia

Immunosuppressants suppresses the immune response and alter antibody formations.

  • True

A licensed health professional who prepares, dispenses and advises on medicinal drugs.

  • Pharmacist

The physician orders 500 mg of ibuprofen for a patient and you have 250 mg on hand. How many tablets should be given? ( 5PTS)

  • 2

Abrupt withdrawal of adrenergic blockers may lead to:

  • Urine retention
  • Hypoglycemia
  • Severe rebound hypertension
  • Severe pain from myocardial ischemia

Which of the following is a sign and symptoms of tardive dyskinesia:

  • Facial grimacing
  • Protrusion of the tongue
  • Restlessness
  • Dysphagia

Mineralocorticoids are used for primary and secondary adrenal sufficiency in Addison’s disease.

  • False

16. Which of the following is not included in client teaching in medication administration?

  • Other medication can be taken if the drug is not available.
  • Dose, route, frequency, and when to take prn meds.
  • Nontherapeutic effects and what to do if sign and symptoms occur.
  • Generic and trade name, purpose, therapeutic effect.

Nursing intervention necessary for client receiving mafenide acetate (Sulfamylon) include:

  • Notify physician if hyperventilation occurs.
  • The medication should be discontinued if the client develops depression.
  • Monitor complete blood cell count, especially the white blood cells.
  • It must not be used if the client is pregnant, as it is highly teratogenic and cause fetal abnormalities.

Dilates the pupils of the eye.

  • none of the above
  • mydriatics
  • miosis
  • cycloplegics

PENTAVALENT VACCINE 5.

  • Hib

The antidote for hypertensive crisis in client taking MAOIs, is:

  • antihistamines
  • tricyclic antidepressants
  • phentolamine
  • phenothiazines

Clients receiving tocolytics should be positioned on her side.

  • To enhance placental perfusion and reduce pressure on the cervix.

Transmucosal-buccal nitrates, the client should be instructed to:

  • place the medication between the upper lip and gum or in the buccal area between the cheek and
  • gum.
  • direct the spray against the oral mucosa
  • inhale the spray
  • do not chew or crush the medication

Clients receiving translingual nitrates (spray), the client should be instructed to:

  • do not chew or crush the medication
  • place the medication between the upper lip and gum or in the buccal area between the cheek and
  • gum.
  • inhale the spray
  • direct the spray against the oral mucosa

When a medication is intended for the trachea, bronchi, and/or lungs, it is inhaled through the nose.

  • False

One of the fetal contraindications of tocolytics is the gestational age greater than 37 weeks.

  • True

Glucocorticoids should be used with caution in clients with diabetes mellitus.

  • True

Clients taking bronchodilators, instruct the client to administer oral medication:

  • With food
  • Crushed enteric-coated tablets
  • On an empty stomach
  • With caffeine containing food

II. Enumeration Give at least five rights in medication administration.

  • Medication, client, dose, time, route

Antineoplastic medication causes the slow destruction of cells, resulting in the release of uric acid.

  • False

Mannitol (Osmitrol) is a:

  • Thiazide and thiazide-like diuretics
  • Potassium-sparing diuretics
  • Loop diuretics
  • Osmotic diuretics

Leukotriene modifiers should be used with caution in clients with impaired hepatic function.

  • True

Lithium has teratogenic effect during 3rd trimester.

  • False

Administer antiemetics several hours before chemotherapy and for 12 to 48 hours after as prescribed.

  • Because antineoplastic medications stimulate the vomiting center in the brain.

Topical applications includes dermatologic preparations, installations and irrigations.

  • True

Silver sulfadiazine (Silvadene, Thermazene, SSD Cream) systemic effects include leukopenia and interstitial nephritis.

  • True

14. The drug specific target usually a protein located on the surface of a cell membrane or within

  • Receptor
  • Antagonist
  • Agonist
  • Reservoir

In administering heparin injection, the nurse should massage the site of injection to hasten drug absorption.

  • False

An acne product where it decreases androgen activity resulting in decrease production of sebum.

  • Isotretinoin (Accutane)
  • Oral antibiotic
  • Oral contraceptives: Spironolactone (Aldactone)
  • Azelaic acid (Azelex)

Which of the following is benzodiazepine antagonist:

  • Clorazepate (Tranxene)
  • Chlordiazepoxide (Librium)
  • Buspirone (BuSpar)
  • Flumazenil (Romazicon)

Toxicity of alpha-adrenergic blockers is treated with:

  • Activated charcoal
  • Atropine
  • Calcium gluconate
  • Naloxone

Glucocorticoids are administered with caution in clients who have inflammatory respiratory conditions.

  • False

The effects urinary tract antiseptics can also be use for infections outside the urinary tract.

  • False

Dexamethasone (Maxidex) should not be used for eye abrasions and wounds.

  • True

Eye lubricant add moisture to the eyes.

  • True

9. Which of the following is not an indication of prostaglandin?

  • Induction of abortion
  • Pre induction cervical ripening
  • Promotes milk letdown
  • Induction of labor

The nurse should administer which medication in clients who developed anaphylactic reaction due to antineoplastic medications?

  • cisplatin (Platinol-AQ)
  • bleomycin sulfate (Blenoxane)
  • diphenhydramine (Benadryl)
  • busulfan (Myleran, Busulfex)

Instruct the client taking anxiolytic medication to avoid alcohol and sedatives because:

  • they increases side effects
  • they decreases drug effects
  • they decreases side effects
  • they increases drug effects

Client receiving magnesium sulfate intravenously, the nurse should call the health care provider if respirations are less than 12 breaths/min.

  • which indicate respiratory depression, or if any other adverse reactions occur.

Parasiticidal prevents worm growth and reproduction (for pinworms).

  • False

Metabolites is the product of biotransformation.

  • True

A gelatinous container to hold a drug in powder, liquid, or oil form.

  • Caplet
  • Lozenge
  • Elixir
  • Capsule

Opioid analgesic

  • Naloxone (Narcan) or nalmefene (Revex)

Spironolactone (Aldactone) is a:

  • Osmotic diuretics
  • Potassium-sparing diuretics
  • Thiazide and thiazide-like diuretics
  • Loop diuretics

MMR vaccine protects against measles, mumps, and rubella.

  • True

Cisplatin (Platinol-AQ) may cause:

  • ototoxicity
  • gonadal suppression
  • hyperuricemia
  • hematuria

Bethanechol chloride (Urecholine)

  • [No Answer]

Penicillins and cephalosporins should be given separately with aminoglycosides.

  • Because Penicillins and cephalosporins may inactivate aminoglycosides

Acetaminophen (Tylenol) is used to decrease pain and fever.

  • True

High doses of oxytocin may cause hypotension, with:

  • rebound hypertension
  • fetal compromise
  • renal impairment
  • myocardial infarction

Instruct the client taking a corticosteroid not to stop the medication abruptly.

  • Because this could result in adrenal insufficiency.

Famotidine (Pepcid) and nizatidine (Axid) can be administered with food.

  • False

Psychological/physiological need to take a medication.

  • Allergic reaction
  • Adverse effect
  • Drug toxicity
  • Drug dependence

Sustained-released nitrates, the client should be instructed to:

  • inhale the spray
  • direct the spray against the oral mucosa
  • place the medication between the upper lip and gum or in the buccal area between the cheek and
  • gum.
  • do not chew or crush the medication

6. The rate and extent to which an administered drug reaches the systemic circulation.

  • Absorption
  • Metabolism
  • First-pass metabolism
  • Bioavailability

Leukotriene increases bronchoconstriction caused by antigen and reduce airway edema.

  • False

Common complaint of clients taking an ACE inhibitor.

  • Hypertension
  • Hypoglycemia
  • Dizziness
  • Persistent cough

Which of the following is not included in atropine toxicity.

  • Photophobia
  • Urinary retention
  • Dry mouth
  • Dermatitis

9. It is a maintained concentration of a drug in the plasma during a series of scheduled doses.

  • Drug half life
  • Onset of action
  • Plateau
  • Peak plasma level

For clients who are taking selective serotonin reuptake inhibitors (SSRI) should be administer with a snack or meal.

  • To reduce the risk of dizziness and lightheadedness.

The nurse should administer adrenergic agonist through a large vein.

  • To decrease incidence of extravasation.

An example of calcium channel blockers.

  • Amlodipine (Norvasc)
  • Prazosin (Minipress)
  • Propranolol (Inderal)
  • Nitroglycerin

Which immunomodulator agents induce more rapid bone marrow recovery after suppression by chemotherapy?

  • Colony-stimulating factors
  • Interferons
  • Immunomodulators
  • Interleukins

Nitrates are contraindicated in clients with:

  • Hyperglycemia
  • Edema
  • Hypertension
  • Hypotension

Bethanechol chloride is give only by:

  • Intramuscular and intravenous
  • Subcutaneous and intramuscular
  • Mouth and intravenous
  • Mouth and subcutaneous

Sodium nitroprusside should protect from light.

  • Because the medication decomposes.

Which of the following blood levels that needs to be monitored if the client is receiving Heparin sodium:

  • Platelet count
  • Prothrombin time (PT)
  • Activated partial thromboplastin time (aPTT)
  • Hematocrit

Give the rationale of the following nursing intervention for clients receiving medications for respiratory system. 2 points each.

  • To prevent crystalluria.
  • Instruct the client receiving streptomycin to notify the physician if hearing loss, changes in
  • vision, or urinary problems occur.
  • Answer 2
  • Because streptomycin may cause nephrotoxicity, neurotoxicity, auditory ototoxicity.
  • Clients receiving ethionamide (Trecator) may need to give pyridoxine as prescribed.
  • Answer 3
  • To reduce the risk of neurotoxicity.
  • Client receiving cycloserine (Seromycin) should be monitored for serum drug level.
  • Answer 4
  • To avoid the risk of neurotoxicity
  • Before receiving ethambutol, the nurse should obtain baseline visual acuity and color discrimination, especially to green.
  • Answer 5
  • Because of the side effect is optic neuritis.

Atypical new generation medication decreases effects of dopamine serotonin and/or norepinephrine at neural membranes.

  • False

The vaccines should be stored on a center shelf and not on the door.

  • Because frequent temperature changes from opening the refrigerator door can alter the vaccine’s potency.

An example of alpha adrenergic blockers.

  • Nitroglycerin
  • Amlodipine (Norvasc)
  • Prazosin (Minipress)
  • Propranolol (Inderal)

Physician orders 1500 mg of liquid ibuprofen for a patient. Quantity of Ibuprofen is 500 mg in 1 cc, how much will you administer?

  • 3 cc

Client taking antigout medication should be instructed to avoid foods high in purine.

  • True

Varicella vaccine protects against:

  • hepatitis B
  • pneumonia
  • chicken pox
  • measles

5. The time interval required for the body’s elimination processes to reduce the concentration of the drug in the body by one-half.

  • [No Answer]

Antitumor antibiotic medication, pulmonary toxicity can occur with:

  • All of the above
  • Doxorubicin (Adriamycin, Doxil) and idarubicin (Idamycin)
  • Daunorubicin (DaunoXome)
  • bleomycin (Blenoxane)

In administering eye medication, instruct the client to read the medication labels carefully.

  • To ensure administration of the correct medication and correct strength.

Which of the following is a sign and symptoms of Akathisia:

  • Protrusion of the tongue
  • Restlessness
  • Facial grimacing
  • Dysphagia

Nasal decongestant can be use in client with allergic rhinitis and acute coryza.

  • True

If gold toxicity occurs, the doctor may prescribe dimercaprol (BAL in oil) to prevent gold excretion.

  • False

In client taking oral contraceptives, advise the client to use an alternate method of birth control when taking antibiotics.

  • Because these may decrease absorption of the oral contraceptive.

Unexpected or unique response.

  • Drug habituation
  • Drug tolerance
  • Idiosyncratic effect
  • Side effect

Clients taking loop diuretics should be advised to:

  • take the medication on empty stomach
  • take the medication before meals
  • take the medication at night
  • take the medication in the morning

Monitor kidney and liver function studies.

  • Because the kidneys and liver are where most antibiotics are metabolized

Sulfonamides is contraindicated in children younger than 2 years.

  • False

Opioid antagonist used to treat respiratory depression from opioid overdose.

  • True

Bronchodilators are indicated in clients with emphysema and other restrictive airway disease.

  • True

3 1/2 MONTH 7.

  • Inactivated polio vaccine (IPV)

Vastus lateralis muscle is the recommended site of intramuscular injection in young adult.

  • False

Promote a fluid intake of at least 2000 mL/ day.

  • To maintain adequate renal function.

The process by which metabolites and drugs are eliminated from the body.

  • ELIMINATION

Benzodiazepines should administer at no more than 5 mg/min intravenously to prevent bradycardia.

  • TRUE

Thyroid hormones control the metabolic rate of tissues and decreases heat production and oxygen consumption of the body.

  • False

Skeletal muscle relaxant is contraindicated in clients with multiple sclerosis and brain attack.

  • False

Phenytoin decreases the effectiveness of some birth control pills and can have teratogenic effects if taken during pregnancy.

  • TRUE

Adrenergic agonist is for:

  • Myasthenia gravis
  • Angle-closure glaucoma
  • Relieving symptoms of Parkinson’s disease
  • Hypotension

Client receiving Nifedipine (Procardia, Adalat, Nifedical) should avoid use or use cautiously with magnesium sulfate, to prevent which of the following?

  • Severe hypotension
  • Liver toxicity
  • Severe hypertension
  • Kidney toxicity

Acetaminophen

  • Acetylcysteine (Mucomyst)

Sympathomimetic medication is used to treat hypertension, heart failure and cardiac arrest.

  • False

7. Which of the following factors influencing absorption is not included?

  • Application of heat
  • Acid in the stomach
  • Food
  • Solubility of the drug

Client receiving antineoplastic medication should avoid aspirin-containing products.

  • to prevent infection
  • to minimize the risk of bleeding
  • to prevent neutropenia
  • to prevent developing Reye’s syndrome

Alpha adrenergic blocker should be taken with food or milk.

  • To decrease gastric irritation.

Due to immaturity of liver and kidney function in older client, it may lead to accumulation of the drug in the body.

  • False

Bile acid sequestrants should use cautiously in clients with suspected bowel obstruction or severe constipation.

  • Because they can worsen these conditions.

Meperidine hydrochloride (Demerol) and hydromorphone hydrochloride (Dilaudid) should not administered in early labor.

  • Because it may slow the labor process.

Supports body function until other treatments or the body’s response can take over.

  • Substitutive
  • Restorative
  • Supportive
  • Curative

May be carried out indefinitely until an order is written to cancel it.

  • Stat order
  • Single order
  • PRN order
  • Standing order

Children receiving the Varicella vaccine should avoid aspirin or aspirin-containing products.

  • Because of the risk of Reye’s syndrome.

Dopamine decreases the myocardial contractility thus, improving cardiac performance.

  • False

Cardiac glycosides produce a negative chronotropic action, which:

  • Increases the heart rate
  • Slows the heart rate
  • Decreases the force of myocardial contractions
  • Increase the force of myocardial contractions

Instruct the client taking lithium (Lithobid) to maintain a fluid intake of six to eight glasses of water a day and an adequate salt intake.

  • To prevent lithium toxicity.

______________5. Sunscreen should be reapplied every 30 minutes for increase protection.

  • True
  • False

______________8. Diclofenac sodium (Solaraze) is used in conjunction with blue light photoactivation in treating actinic keratosis.

  • True
  • False

8. Most drug metabolites are eliminated in the:

  • Liver
  • Breath
  • Kidneys
  • Stool

Cimetidine (Tagamet) passes the blood-brain barrier.

  • True

7. If magnesium sulfate is used for preeclampsia, it may be prescribed:

  • 6 months after pregnancy
  • 12-24 hours postpartum
  • during labor
  • during pregnancy

Theophylline is a glucocorticoid medication.

  • False

Mydriatics are should not be given in clients with glaucoma.

  • Because of the risk of increased intraocular pressure.

Mydriatics are contraindicated in clients with glaucoma because of the risk of decreased intraocular pressure.

  • False

Dr. B. orders a liter of D5W to run this 8-hour shift. The drop factor is 15. What is the drip rate per minute?

  • [No Answer]

The client with HIV or AIDS is at high risk for the development of:

  • nausea and vomiting
  • nephrotoxicity
  • alopecia
  • opportunistic infections

TRUE OR FALSE

  • True
  • Fertility medication is contraindicated in the presence of primary ovarian dysfunction, thyroid or adrenal dysfunction, ovarian cysts, pregnancy, or idiopathic uterine bleeding.
  • Answer 2
  • Sulfonylureas can cause a disulfiram (Antabuse) type of reaction when alcohol is ingested. TRUE
  • Answer 3
  • False
  • Antiemetic drugs work by acting on the central nervous system to prevent nausea and vomiting.
  • Answer 4
  • Rotarix vaccine have 2 doses.
  • Answer 5
  • Food reduces the rate of absorption of Cimetidine (Tagamet).
  • Answer 6
  • For client taking alkylating medications, the nurse should withhold medication if the platelet count is more than 75,000/mm3.
  • Answer 7
  • Ranitidine (Zantac) side effects are common but does not penetrate the blood- brain barrier.
  • Answer 8
  • Diphtheria, tetanus, acellular pertussis (DTaP) is for adolescent preparation.
  • Answer 9
  • Nurses who are pregnant can do chemotherapy preparation or the administration of chemotherapy.
  • Answer 10
  • For Hep B vaccine, if the mother’s HBsAg test result is positive, the infant should receive HBIG after 1 week of age.
  • Answer 11
  • You have correctly selected 7.

10. Placement of drug under the tongue.

  • Intradermal
  • Oral
  • Sublingual
  • Buccal

In nasal medication, the client is advised to blow their noses after the administration of nasal sprays.

  • False

PENTAVALENT VACCINE 3.

  • DPT

The therapeutic drug serum level of lithium is:

  • 0.4 to 0.8 mEq/L
  • 0.6 to 1.2 mEq/L
  • 1 to 2 mEq/L
  • 0.8 to 1.6 mEq/L

Cardiac glycoside is used in clients with cardiogenic shock.

  • True

Administer analgesic as prescribed to client’s receiving ergot alkaloids.

  • They may be required because the medication produces painful uterine contractions.

Returns the body to health.

  • Substitutive
  • Chemotherapeutic
  • Restorative
  • Supportive

Which of the following is a sign and symptoms of Parkinsonism:

  • Facial grimacing
  • Restlessness
  • Protrusion of the tongue
  • Dysphagia

Monitor liver function tests when a client is taking a skeletal muscle relaxant because neurotoxicity can occur.

  • False

15. The pharmacologic effects when the drug produces the same type of response as the physiological or endogenous substance.

  • Receptor
  • Antagonist
  • Reservoir
  • Agonist

Which of the following is a sign and symptoms of dystonia:

  • Protrusion of the tongue
  • Facial grimacing
  • Restlessness
  • Dysphagia

When applying eye drops, the nurse should instruct the client to apply pressure over the inner canthus next to the nose for 30 to 60 seconds following administration of the medication.

  • To prevent overflow of medication into the nasal and pharyngeal passages, thus reducing systemic absorption.

When receiving positive inotropic and cardiotonic medications, the nurse should monitor for?

  • Femoral pulse
  • Number of breathing per minute
  • Consciousness
  • Apical pulse

Instruct the client taking amiodarone to use sunscreen and protective clothing.

  • To prevent photosensitivity reactions.

In client taking glucocorticoids, the nurse should use this medication with extreme caution in clients with infections.

  • Because they mask the signs and symptoms of an infection.

Neuromuscular blockers is used with anesthetics during surgery to maintain muscle relaxation.

  • TRUE

Enteric coated medication can be crush and mix with food if the client has difficulty swallowing.

  • False

Metered-dose inhaler (MDI) is a handheld nebulizer that can be used by the client to release the medication through a mouthpiece.

  • True

Busulfan (Myleran, Busulfex) may cause:

  • hyperuricemia
  • ototoxicity
  • gonadal suppression
  • hematuria

Aspirin should be discontinued 3 to 7 days before surgery.

  • To reduce the risk of bleeding.

______________9. High-dose of anthralin (Dritho-Scalp, Psoriatec) may cause hypercalcemia.

  • True
  • False

Client who are taking medication through sublingual route should be advised to keep the medication under the tongue until it is absorbed.

  • True

______________3. Organic (chemical) sunscreens absorb UV light.

  • True
  • False

20. Solution injected into intravascular compartment via a vein.

  • Intramuscular route
  • Subcutaneous route
  • Intravenous route
  • Parenteral route

Transdermal patch is applied to a hairless, clean area of skin that is subject to excessive movement or wrinkling.

  • False

Vaccines administered intramuscularly for children 36 months and older are best given in:

  • lateral upper arms
  • deltoid muscle
  • dorsogluteal muscle
  • vastus lateralis muscle

A preparation like an ointment, but thicker and stiff, that penetrates the skin less than an ointment.

  • Paste
  • Liniment
  • Elixir
  • Cream

In irrigation of the ear, the doctor may prescribe hydrogen peroxide solution.

  • [No Answer]

Give the antidote of the following medications. 2 points each.

  • Protamine sulfate

Pilocarpine

  • Atropine sulfate

Early signs of digoxin toxicity present as:

  • Dizziness
  • Gastrointestinal manifestations
  • Visual disturbances
  • Heart rate abnormalities

When using a bronchodilator inhalant in addition to the steroid inhalant, use the steroid at least 5 minutes prior to the bronchodilator.

  • TRUE

17. Tablet held between cheek and gum until dissolved.

  • Transdermal
  • Sublingual
  • Buccal
  • Oral

Anticholinergic medication is also known as cholinergic-blocking agents.

  • True

Hepatitis A vaccine (HepA) administration route is:

  • Oral route
  • Intradermal route
  • Intramuscular route
  • Subcutaneous route

Also known as one-time order is for medication to be given once at a specified time.

  • Single order
  • PRN order
  • Stat order
  • Standing order

The best route in allergy testing and tuberculosis screening is intradermal route.

  • True

______________6. In using sunscreens, products containing PABA need to be used by individuals allergic to benzocaine, sulfonamides, or thiazides.

  • True
  • False

Client taking alpha adrenergic blocker should be instructed to change positions slowly.

  • [No Answer]

Placement under the tongue allows a drug to diffuse into the capillary network and to enter the systemic circulations indirectly.

  • False

Inform the client using eye gel to store the gel at room temperature or in the refrigerator.

  • TRUE

For clients taking MAOI, avoid administering the medication in the evening.

  • Because insomnia may result.

Glucocorticoids is intended for acute respiratory attacks.

  • TRUE

______________1. Growth retardation is one of the systemic adverse effects of topical glucocorticoids.

  • True
  • False

13. The time after administration when the body initially responds to the drug.

  • Plateau
  • Onset of action
  • Drug half life
  • Peak plasma level

Nursing intervention necessary for client receiving silver sulfadiazine (Silvadene, Thermazene,

  • It must not be used if the client is pregnant, as it is highly teratogenic and cause fetal abnormalities.
  • Monitor complete blood cell count, especially the white blood cells.
  • The medication should be discontinued if the client develops depression.
  • Notify physician if hyperventilation occurs.

BIRTH 1.

  • Hepatitis B vaccine (HepB)

Benzodiazepines are contraindicated in clients with anxiety.

  • False

Which of the following is not included in estrogen hormonal medications?

  • Ethinyl estradiol (Estinyl)
  • Fulvestrant (Faslodex)
  • Diethylstilbestrol
  • Estramustine (Emcyt)

Antigout medications can increase desired effect by taking aspirin.

  • False

The following drug is used for moderate and severe dementia and Alzheimer’s disease.

  • Galantamine (Razadyne)
  • Memantine (Namenda)
  • Rivastigmine (Exelon)
  • Donepezil (Aricept)

Client taking isoniazid should be instructed to monitor for tingling, numbness, or burning of the extremities because these are signs of hepatotoxicity.

  • False

Magnesium sulfate is contraindicated in clients with myocardial damage.

  • True

Instruct the client taking fluoxetine (Prozac) or bupropion (Wellbutrin) to take the medication early in the day.

  • To prevent interference with sleep.

NSAIDs medication is included in antigout medication.

  • True

Clients with asthma can use mucolytic agents to increase airway resistance.

  • False

Which of the following prevents conversion of HIV RNA into HIV DNA?

  • Protease inhibitors
  • Fusion inhibitors
  • Non-nucleoside reverse transcriptase inhibitors
  • Nucleoside-nucleotide reverse transcriptase inhibitors

_____________10. Coal tar can stain the skin and hair.

  • True
  • False

PENTAVALENT VACCINE 4.

  • HepB

CNS depressants have a calming effect on children with attention-deficit hyperactivity disorder and increase alertness and sensitivity to stimuli.

  • False

Toxicities and overdose by the oral route may be overcome with antidotes, such as activated charcoal.

  • True

Osmotic medication is used for emergency treatment of glaucoma.

  • True

If the client decides to discontinue the contraceptive to become pregnant, recommend that the client use an alternative form of birth control for 2 months after discontinuation.

  • To ensure more complete excretion of hormonal agents before conception.

MMR vaccine administration route is:

  • Intradermal route
  • Intramuscular route
  • Subcutaneous route
  • Oral route

1. Assigned by the United States Adopted Names (USAN) Council and is used throughout the drug’s lifetime.

  • Trade name
  • Official name
  • Chemical name
  • Generic name

In using sunscreens, products containing PABA need to be avoided by individuals allergic to benzocaine, sulfonamides, or thiazides.

  • True

Give the rationale of the following nursing intervention for clients receiving medications for cardiovascular system. 2 points each.

  • To prevent administering a form that contains epinephrine or preservatives because these solutions are used for local anesthesia only.

Tricyclic antidepressant clomipramine (Anafranil) may be used to treat obsessive- compulsive disorder.

  • True

Immunosuppressants used for the following except?

  • transplant recipient
  • autoimmune disorder
  • impaired live function
  • rheumatoid arthritis

Buspirone effect takes 3-6 weeks, which is shorter than other anxiolytics.

  • false

Replaces body fluids or substances.

  • Chemotherapeutic
  • Supportive
  • Substitutive
  • Palliative

Severe side effect or toxicity.

  • Adverse effect
  • Allergic reaction
  • Drug dependence
  • Drug toxicity

18. Best route in administering drugs that are poorly absorbed from the GI tract and for agents that are unstable in GI tract.

  • Parenteral route
  • Intramuscular route
  • Subcutaneous route
  • Intravenous route

A medication mixed with alcohol, oil, or soapy emollient and applied to the skin.

  • Cream
  • Paste
  • Liniment
  • Elixir

This site should be avoided when injecting vaccine in intramuscular route:

  • vastus lateralis muscle
  • deltoid muscle
  • dorsogluteal muscle
  • lateral upper arms
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