2
Pharmacotherapeutics Exam 3 with verified detailed solutions || || || || || ||
A patient with systemic lupus erythematosus is prescribed
|| || || || || || ||
prednisone. It is most important for the nurse to monitor the patient for what?
|| || || || || || || || || || || || ||
A. Hypotension
||
B. Elevated potassium levels
|| || ||
C. Neck and back pain
|| || || ||
D. Hypoglycemia - ✔✔Answer: C
|| || || ||
Rationale: Neck and back pain from a vertebral compression fracture may occur because of
|| || || || || || || || || || || || || ||
the development of osteoporosis as a result of glucocorticoid therapy. Other possible adverse
|| || || || || || || || || || || ||
effects of prednisone include hypertension, hypokalemia, and hyperglycemia.
|| || || || || || || ||
*Reference Ch. 72 - Gluocorticoids* || || || ||
A patient has been prescribed pharmacologic doses of glucocorticoids. It is most important
|| || || || || || || || || || || || ||
for the nurse to teach the patient to do what?
|| || || || || || || || ||
A. Increase intake of dietary sodium.
|| || || || ||
B. Take antibiotics to prevent infection.
|| || || || ||
C. Never abruptly withdraw therapy.
|| || || ||
D. Have an eye examination every year. - ✔✔Answer: C
|| || || || || || || || ||
Rationale: Abrupt withdrawal of glucocorticoids may cause adrenal insufficiency or an
|| || || || || || || || || || ||
adrenal crisis. Infection should be prevented, but the use of antibiotics without a known
|| || || || || || || || || || || || || ||
infection is inappropriate. Sodium intake should be restricted while the patient is taking
|| || || || || || || || || || || || ||
glucocorticoids. Eye examinations are recommended every 6 months for patients on || || || || || || || || || || ||
glucocorticoid therapy. ||
,2
*Reference Ch. 72 - Glucocorticoids* || || || ||
A patient has been receiving long-term prednisone therapy for treatment of rheumatoid
|| || || || || || || || || || || ||
arthritis. The chart indicates that the patient has developed Cushing's syndrome. When
|| || || || || || || || || || || ||
performing a physical assessment, the nurse anticipates finding all but which manifestation
|| || || || || || || || || || || ||
of Cushing's syndrome?
|| ||
A. Hypoglycemia
||
B. Muscle weakness
|| ||
C. Glucosuria
||
D. "Buffalo hump" - ✔✔Answer: A
|| || || || ||
Rationale: Cushing's syndrome is manifested by hyperglycemia, glycosuria, fluid and
|| || || || || || || || || ||
electrolyte disturbances, osteoporosis, muscle weakness, cutaneous striations, and lowered
|| || || || || || || || ||
resistance to infection. Redistribution of fat produces a "potbelly," "moon face," and "buffalo
|| || || || || || || || || || || || ||
hump."
*Reference Ch. 72 - Glucocorticoids* || || || ||
A patient with rheumatoid arthritis has been taking high-dose aspirin and complains of
|| || || || || || || || || || || || ||
gastric upset and pain. What does the nurse anticipate will be prescribed for this patient?
|| || || || || || || || || || || || || ||
A. Taking a lower dose of aspirin
|| || || || || ||
B. Biweekly injections of methotrexate [Rheumatrex]
|| || || || ||
C. Obtaining a prescription for celecoxib [Celebrex]
|| || || || || ||
D. Daily drug therapy with prednisone - ✔✔Answer: C
|| || || || || || || ||
Rationale: If aspirin causes gastrointestinal upset or pain, a cyclooxygenase-2 (COX-2)
|| || || || || || || || || || ||
inhibitor (celecoxib) should be considered. Methotrexate is administered once a week. Daily
|| || || || || || || || || || ||
, 2
prednisone therapy is not indicated; prednisone is usually administered for exacerbations
|| || || || || || || || || || || ||
and as short-term therapy.
|| || ||
*Reference Ch. 73 - Rheumatoid Arthritis* || || || || ||
A patient with rheumatoid arthritis is prescribed methotrexate [Rheumatrex]. The nurse
|| || || || || || || || || || ||
will expect to observe therapeutic effects with this drug in which time period?
|| || || || || || || || || || || ||
A. 3 to 7 days
|| || || ||
B. 3 to 6 weeks
|| || || ||
C. 3 to 4 months
|| || || ||
D. 1 to 2 years - ✔✔Answer: B
|| || || || || || ||
Rationale: Methotrexate acts faster than all other disease-modifying antirheumatic drugs.
|| || || || || || || || || ||
Therapeutic effects may develop in 3 to 6 weeks. || || || || || || || ||
*Reference Ch. 73 - Rheumatoid Arthritis* || || || || ||
A patient with acute gouty arthritis requests information on the preferred drug to take to
|| || || || || || || || || || || || || || ||
treat a painful flare-up. The nurse should recommend which medication?
|| || || || || || || || ||
A. Allopurinol
||
B. Febuxostat
||
C. Probenecid
||
D. Naproxen - ✔✔Answer: D
|| || || ||
Rationale: NSAIDs and glucocorticoids are preferred drugs for treating acute gouty attacks.
|| || || || || || || || || || || ||
Benefits derive mainly from anti-inflammatory actions. Four drugs—allopurinol,
|| || || || || || || ||
febuxostat, probenecid, and pegloticase—are used long term to prevent gouty attacks.
|| || || || || || || || || || ||
Benefits derive from lowering plasma uric acid levels. These drugs lack anti-inflammatory
|| || || || || || || || || || || ||
Pharmacotherapeutics Exam 3 with verified detailed solutions || || || || || ||
A patient with systemic lupus erythematosus is prescribed
|| || || || || || ||
prednisone. It is most important for the nurse to monitor the patient for what?
|| || || || || || || || || || || || ||
A. Hypotension
||
B. Elevated potassium levels
|| || ||
C. Neck and back pain
|| || || ||
D. Hypoglycemia - ✔✔Answer: C
|| || || ||
Rationale: Neck and back pain from a vertebral compression fracture may occur because of
|| || || || || || || || || || || || || ||
the development of osteoporosis as a result of glucocorticoid therapy. Other possible adverse
|| || || || || || || || || || || ||
effects of prednisone include hypertension, hypokalemia, and hyperglycemia.
|| || || || || || || ||
*Reference Ch. 72 - Gluocorticoids* || || || ||
A patient has been prescribed pharmacologic doses of glucocorticoids. It is most important
|| || || || || || || || || || || || ||
for the nurse to teach the patient to do what?
|| || || || || || || || ||
A. Increase intake of dietary sodium.
|| || || || ||
B. Take antibiotics to prevent infection.
|| || || || ||
C. Never abruptly withdraw therapy.
|| || || ||
D. Have an eye examination every year. - ✔✔Answer: C
|| || || || || || || || ||
Rationale: Abrupt withdrawal of glucocorticoids may cause adrenal insufficiency or an
|| || || || || || || || || || ||
adrenal crisis. Infection should be prevented, but the use of antibiotics without a known
|| || || || || || || || || || || || || ||
infection is inappropriate. Sodium intake should be restricted while the patient is taking
|| || || || || || || || || || || || ||
glucocorticoids. Eye examinations are recommended every 6 months for patients on || || || || || || || || || || ||
glucocorticoid therapy. ||
,2
*Reference Ch. 72 - Glucocorticoids* || || || ||
A patient has been receiving long-term prednisone therapy for treatment of rheumatoid
|| || || || || || || || || || || ||
arthritis. The chart indicates that the patient has developed Cushing's syndrome. When
|| || || || || || || || || || || ||
performing a physical assessment, the nurse anticipates finding all but which manifestation
|| || || || || || || || || || || ||
of Cushing's syndrome?
|| ||
A. Hypoglycemia
||
B. Muscle weakness
|| ||
C. Glucosuria
||
D. "Buffalo hump" - ✔✔Answer: A
|| || || || ||
Rationale: Cushing's syndrome is manifested by hyperglycemia, glycosuria, fluid and
|| || || || || || || || || ||
electrolyte disturbances, osteoporosis, muscle weakness, cutaneous striations, and lowered
|| || || || || || || || ||
resistance to infection. Redistribution of fat produces a "potbelly," "moon face," and "buffalo
|| || || || || || || || || || || || ||
hump."
*Reference Ch. 72 - Glucocorticoids* || || || ||
A patient with rheumatoid arthritis has been taking high-dose aspirin and complains of
|| || || || || || || || || || || || ||
gastric upset and pain. What does the nurse anticipate will be prescribed for this patient?
|| || || || || || || || || || || || || ||
A. Taking a lower dose of aspirin
|| || || || || ||
B. Biweekly injections of methotrexate [Rheumatrex]
|| || || || ||
C. Obtaining a prescription for celecoxib [Celebrex]
|| || || || || ||
D. Daily drug therapy with prednisone - ✔✔Answer: C
|| || || || || || || ||
Rationale: If aspirin causes gastrointestinal upset or pain, a cyclooxygenase-2 (COX-2)
|| || || || || || || || || || ||
inhibitor (celecoxib) should be considered. Methotrexate is administered once a week. Daily
|| || || || || || || || || || ||
, 2
prednisone therapy is not indicated; prednisone is usually administered for exacerbations
|| || || || || || || || || || || ||
and as short-term therapy.
|| || ||
*Reference Ch. 73 - Rheumatoid Arthritis* || || || || ||
A patient with rheumatoid arthritis is prescribed methotrexate [Rheumatrex]. The nurse
|| || || || || || || || || || ||
will expect to observe therapeutic effects with this drug in which time period?
|| || || || || || || || || || || ||
A. 3 to 7 days
|| || || ||
B. 3 to 6 weeks
|| || || ||
C. 3 to 4 months
|| || || ||
D. 1 to 2 years - ✔✔Answer: B
|| || || || || || ||
Rationale: Methotrexate acts faster than all other disease-modifying antirheumatic drugs.
|| || || || || || || || || ||
Therapeutic effects may develop in 3 to 6 weeks. || || || || || || || ||
*Reference Ch. 73 - Rheumatoid Arthritis* || || || || ||
A patient with acute gouty arthritis requests information on the preferred drug to take to
|| || || || || || || || || || || || || || ||
treat a painful flare-up. The nurse should recommend which medication?
|| || || || || || || || ||
A. Allopurinol
||
B. Febuxostat
||
C. Probenecid
||
D. Naproxen - ✔✔Answer: D
|| || || ||
Rationale: NSAIDs and glucocorticoids are preferred drugs for treating acute gouty attacks.
|| || || || || || || || || || || ||
Benefits derive mainly from anti-inflammatory actions. Four drugs—allopurinol,
|| || || || || || || ||
febuxostat, probenecid, and pegloticase—are used long term to prevent gouty attacks.
|| || || || || || || || || || ||
Benefits derive from lowering plasma uric acid levels. These drugs lack anti-inflammatory
|| || || || || || || || || || || ||
