Nurs 521 Pharmacology Exam Practice Study Guide Questions and Verified Solutions 2026

Nurs 521 Pharmacology Exam Practice Study Guide Questions and Verified Solutions 2026 1st generation NSAIDS inhibit: a. COX-1 only b. COX-2 only c. COX-1 and COX-2 - Correct Ans-C 2nd generation NSAIDS inhibit: a. COX-1 only b. COX-2 only c. COX-1 and COX-2 - Correct Ans-B A 25-year-old woman on fluoxetine (Prozac), a stimulating antidepressant, has trouble with falling asleep. You would expect which of the following drugs to be used? a. Lorazepam (Ativan) b. Buspirone (BuSpar) c. Trazodone (Desyrel) d. Diphenhydramine (Benadryl) - Correct Ans-C A 37-year old female patient has just been admitted to your clinic for a chief complaint of diarrhea. Your client states, "I have trouble concentrating, I feel hot and sweaty all the time, and I'm eating ALL the time but losing weight! Also, for some reason my eyes look like they're bulging out of my head." Which of the following disease's do you suspect your patient of having based on these symptoms? a. Hashimoto's disease b. Type II diabetes c. Menopause d. Grave's disease - Correct Ans-D A COX-1 inhibitor medication benefits the body by: a. Suppressing inflammation b. Reducing fever c. Preventing platelet aggregation d. Relieving pain - Correct Ans-C NSG 6020 NSG 6020 NSG 6020 A nurse assesses a patient who takes a maintenance dose of lithium carbonate (Lithobid) for bipolar disorder. The patient complains of hand tremor, nausea, vomiting, and diarrhea. The patient's gait is unsteady. What might the nurse suspect in this situation? The patient: a. may have consumed some foods high in tyramine. b. has not taken the lithium as directed. c. has probably developed tolerance to the lithium. d. may have developed lithium toxicity. - Correct Ans-D A nurse is educating a patient knowledge they should know when taking COX inhibitors (both 1 and 2). Which of the following statements made by the patient requires further instruction? a. "I should use a soft bristle toothbrush to prevent my gums from bleeding." b. "I should take a blood thinner while on this medication to reduce it's side effects." c. "I should be careful about running into things, like a table, to prevent bruising." d. "I should expect to see a relief of pain, fever, and inflammation when taking this." - Correct Ans-B A nurse should recognize that a patient who is receiving an angiotensin-converting enzyme (ACE) inhibitor medication while also receiving aspirin is at risk to develop which of these complications? a. Aspirin poisoning b. Liver toxicity c. Renal failure d. Hemorrhage - Correct Ans-C (High-dose aspirin should be avoided in patients taking ACE inhibitor medications. In susceptible patients, these medications can impair renal function when they are combined with aspirin. Aspirin overdose causes poisoning. Liver toxicity and hemorrhage are not effects from ACE inhibitors and aspirin interactions.) A nurse teaches a patient who is taking daily low-dose aspirin for protection against myocardial infarction and stroke to also avoid taking which of these medications? a. Ibuprofen (Motrin) b. Zolpidem (Ambien) c. Loratadine (Claritin) d. Diphenhydramine (Benadryl) - Correct Ans-A (Ibuprofen can block the antiplatelet effects of aspirin, and patients who take low-dose aspirin to protect against myocardial infarction and thrombosis should avoid ibuprofen. It is not necessary to avoid taking zolpidem, loratadine, or diphenhydramine while taking aspirin.) A nurse teaches a patient who takes an MAO inhibitor about important dietary restrictions. Which foods will the nurse caution the patient to avoid? NSG 6020 NSG 6020 a. Aged cheese and sherry b. Grapefruit and other citrus juices c. Coffee, colas, and tea d. Potato and corn chips - Correct Ans-A A patient has been admitted to the emergency room with myxedema crisis, or severe life-threatening hypothyroidism, and is non-responsive. Which of the following medications would you anticipate the physician to order to treat this condition? a. Levothyroxine b. Liothyronine c. Methimazole d. Propylthiouracil - Correct Ans-B (Liothyronine has a rapid onset of action in myxedema coma.) A patient has been given instructions about levothyroxine (Synthroid). Which of these statements, if made by the patient, would indicate that the patient understands the instructions? a. " I'll take this medication in the morning so as not to interfere with sleep." b. " I'll plan to double my dose if I gain more than 1 pound per day." c. " I'll be glad when I don't have to take this medication in a few months." - Correct Ans A (Levothyroxine is used to treat hypothyroidism by increasing basal metabolism and thus wakefulness. It is administered as a once-daily dose and a lifelong therapy and is best taken on an empty stomach to enhance absorption.) A patient has just walked into the clinic you work at and exhibits signs of brittle hair as well as hair loss. They also have a very puffy, expressionless face. Which of the following conditions would this patient be suspected of having? a. Hypothyroidism b. Grave's disease c. Cretinism d. Thyrotoxicosis - Correct Ans-A A patient is admitted to the ER with a pulse of 180, temperature of 105.7, blood pressure of 78/40, and is unconscious. Upon assessment, their muscles have atrophied and the patient looks underweight. Upon reviewing their medical history, you learn that they have hyperthyroidism and just recently had a major open heart surgery. Which of the following conditions do you suspect has occurred because of their hyperthyroidism and symptoms? a. Hypoglycemia b. Drug overdose c. Congestive heart failure d. Thyrotoxic crisis - Correct Ans-D NSG 6020 NSG 6020 A patient taking a benzodiazepine orally would most likely exhibit which group of symptoms during acute toxicity? a. Drowsiness, lethargy, confusion b. Profound hypotension, respiratory arrest, cardiac arrest c. Nausea, vomiting, diarrhea d. Panic, delirium, seizures - Correct Ans-A A patient taking a MAOI complains of a severe headache, chest pain, nausea, vomiting, and sweating. Upon questioning, they state they ate avocado toast for breakfast. What medical condition do you suspect this patient of having? a. Hypertensive crisis b. Hypoglycemia c. Thyroid storm d. Anaphylactic reaction - Correct Ans-A A patient taking Bupropion for smoking cessation may experience all of the following side effects EXCEPT: a. Seizures b. Weight loss c. Constipation d. Bradycardia - Correct Ans-D (You would experience tachycardia) A patient taking Xanax who suddenly stops their dosage would most likely exhibit which group of significant withdrawal symptoms? a. Nausea, vomiting, diarrhea b. Anxiety, sweating, tremors c. Dizziness, insomnia, constipation d. Panic, delirium, seizures - Correct Ans-D A patient walks into the ER and complains of ringing in the ears, that they feel dizzy and sweaty, and they have a terrible headache. After asking if they have taken any medication, they say to you, "I didn't feel well, so I took a few tablets of aspirin." What condition do you suspect this patient of having? a. Thyrotoxicosis b. Salicylism c. Hypoglycemia d. Hypersensitivity to ASA - Correct Ans-B NSG 6020 NSG 6020 A patient who has arthritis is scheduled to start taking celecoxib (Celebrex). A nurse should recognize which of these factors from the patient's history as a contraindication to taking the medication? a. Hypothyroidism b. Recent heart bypass surgery c. Positive tuberculin skin test d. Allergy to penicillin - Correct Ans-B (Celecoxib should be avoided in patients who have undergone recent heart bypass surgery. Because it does not inhibit COX-1, platelet aggregation is not suppressed. It dose inhibit COX-2 in blood vessels, which results in increased vasoconstriction. Unimpeded platelet aggregation and increased vasoconstriction pose a higher risk of thrombotic events in patients with certain cardiovascular risk factors. Hypothyroidism, a penicillin allergy, and a positive tuberculin skin test are not contraindications to taking celecoxib.) A patient with Graves' disease is treated with iodine-131 (Iodope) therapy. Which of these statements, if made by the patient, would indicate that the patient has the correct understanding of the treatment's effects? a. " I'll have to isolate myself from my family so I don't expose them to radiation." b. " I'm looking forward to feeling better immediately after this treatment." c. "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance." d. " I'll need to take this drug on a daily basis for at least 1 year." - Correct Ans-C (Iodine-131 is usually given as a single treatment to produce remission of Graves' disease. Fatigue, hair loss, and cold intolerance are signs of hypothyroidism, which is a complication from the treatment. Iodine-131 has a quick radioactive decay and half-life, so isolation is not needed, but it can take up to 2 months for the patient to have the desired response.) A patient with thyroid cancer will most likely be prescribed which of the following medications? a. Low-dose Iodine b. High-dose Iodine c. Methimazole d. Levothyroxine - Correct Ans-B A patient would develop a physical dependence to an opioid after taking it for how long? a. One week b. 20 days c. 3 months d. One year - Correct Ans-B A TSH test is ordered on your patient to screen for hyperthyroidism. Which of the following results would you anticipate if the patient did have this condition? NSG 6020 NSG 6020 a. High TSH levels b. Low TSH levels c. Normal TSH levels d. High TRH levels - Correct Ans-B (Low TSH levels=hyperthyroidism, High=hypothyroidism) Agonist-antagonist opioids are contraindicated in what type of patients? a. Children b. Patients who have a physical dependence on pure opioids c. Pregnant patients d. Patients that get nightmares often - Correct Ans-B All of the following adverse effects would occur in a patient given Narcan (an opioid antagonist) EXCEPT: a. Insomnia b. Pain c. Withdrawal d. Tachycardia and tachypnea - Correct Ans-A All of the following are advantages of Buspirone (BuSpar) EXCEPT: a. It does not enhance CNS depression or have cross tolerance with benzodiazepines, barbiturates, and opioids b. It has no sedation or abuse potential c. It reduces the risk of MI and stroke d. It is effective at treating anxiety - Correct Ans-C All of the following are adverse effects of inhibiting COX-1 EXCEPT: a. Liver failure b. Gastric ulceration c. Renal impairment d. Increased bleeding - Correct Ans-A All of the following are effects seen in neonates of mother's taking Carbamazepine EXCEPT: a. Spina bifidia b. Neural tube defects c. Low birth weight d. Fetal vitamin K deficiency (bleeding) - Correct Ans-A All of the following are non-aspirin NSAIDS except for: NSG 6020 NSG 6020 a. Acetaminophen (tylenol) b. Acetylsalicylic acid c. Ibuprofen (Motrin, advil) d. Naproxin (Aleve) - Correct Ans-B (Acetylsalicylic acid is aspirin) All of the following indicate improvement of hyperthyroidism when taking thionamides EXCEPT: a. Decreased HR b. Weight gain c. Weight loss d. Decreased T3 and T4 - Correct Ans-C All of the following medical conditions are contraindications for taking bupropion EXCEPT: a. Pneumonia b. Seizure disorder c. Bulimia d. Head injury - Correct Ans-A (B C and D put a pt. at risk for seizures so they are contraindicated for taking bupropion which increases your chances of having seizures.) All of the following vitals are important to monitor while your patient is on morphine EXCEPT: a. Respiratory rate b. Blood pressure c. Temperature - Correct Ans-C (Morphine lowers RR and BP) All thionamides have the following characteristics: a. Prevention of T4 to T3 conversion in the periphery. b. Inhibition of thyroid hormone synthesis by inhibiting peroxidase. c. Short-half lives. d. Immediate restoration of normalized thyroid hormone levels. - Correct Ans-B Alprazolam (Xanax) is prescribed for an adult with panic attacks. The nurse recognizes that this drug works on which neurotransmitter? a. Norepinephrine b. Acetylcholine c. Serotonin (5-HT) d. Gamma-aminobutyric acid (GABA) - Correct Ans-D (Alprazolam is a benzodiazepine. This class of drugs reduces anxiety by potentiating the action of GABA.) NSG 6020 An antidepressant that increases dopamine will have what effect? a. Increased energy b. Increased libido c. Decreased cravings and dependence d. Decreased anxiety and depression - Correct Ans-C An antidepressant that increases norepinephrine will have what effect? a. Increased energy b. Increased libido c. Decreased cravings d. Decreased anxiety and depression - Correct Ans-A An antidepressant that increases serotonin will have what effect? a. Increased energy b. Increased libido c. Decreased cravings d. Decreased anxiety and depression - Correct Ans-D An equianalgesic dose of a pain medication is equivalent to how much morphine IM? a. 10 mg b. 30 mg c. 100 mg d. 125 mg - Correct Ans-A An overdose of barbiturates causes: a. miosis. b. hypertension. c. hyperthermia. d. respiratory alkalosis. - Correct Ans-A Aspirin is known to decrease the risk of: a. Renal impairment b. Colon cancer c. MI and stroke d. Liver failure - Correct Ans-C Benzodiazepines work by decreasing neuronal excitability by increasing: a. potassium influx into the cell. b. chloride influx into the cell. NSG 6020 NSG 6020 c. sodium influx into the cell. d. calcium influx into the cell. - Correct Ans-B Centrally acting muscle relaxants may cause all of the following adverse effects EXCEPT: a. Renal failure b. CNS depression c. Anticholinergic effects d. Hepatic toxicity - Correct Ans-A COX enzymes produce all of the following EXCEPT: a. Inflammation b. Pain c. Fever d. Erythema - Correct Ans-D COX-1 inhibitors causes an increase in: a. platelet aggregation and gastric acid. b. gastric acid and renal impairment. c. bicarbonate and mucus. d. platelet aggregation and submucosal blood flow. - Correct Ans-B COX-2 inhibitors causes a decrease in: a. inflammation. b. platelet aggregation. c. myocardial infarction. d. stroke. - Correct Ans-A COX-2 is known as the 'bad enzyme' because it: a. Causes inflammation, pain, and fever b. Reduces the risk of colon cancer c. Maintains renal function d. Promotes vasodilation of blood vessels - Correct Ans-A E.V., a chemical engineer, is being started on a SNRI. He asks about the difference between SSRIs and SNRIs. The BEST response is: a. "They both raise serotonin levels, which relieve anxiety and depression." b. "They both raise norepinephrine levels, which increase energy levels and cause slight weight loss." NSG 6020 NSG 6020 NSG 6020 c. "SSRIs and SNRIs both increase serotonin levels, which decrease anxiety and depression. However, SNRIs also increase norepinephrine levels which may result in increased energy levels and slight weight loss." - Correct Ans-C Educating a patient about common side effects of taking opioids, which of the following statements made by the patient about managing or preventing orthostatic hypotension would indicate further instruction? a. "I will change my position slowly when moving in bed or getting out of bed." b. "I will make sure to lie down or sit if I suddenly get dizzy or lightheaded." c. "I will try to get up from bed as little as possible to prevent orthostatic hypotension." d. "I will have a friend or family member help me get around in case I suddenly fall." - Correct Ans-C Fentanyl is how much more potent than morphine? a. 10X b. 50X c. 100X d. 200X - Correct Ans-C How do barbiturates affect the blood levels of other drugs? a. Inhibit hepatic enzymes, increasing blood levels. b. Inhibit hepatic enzymes, decreasing blood levels. c. Induce hepatic enzymes, increasing blood levels. d. Induce hepatic enzymes, decreasing blood levels. - Correct Ans-D If your patient is taking opioids due to addiction and not because of pain, which of the following side effects will most likely be exhibited? a. Euphoria b. Dysphoria c. Sedation d. Respiratory depression - Correct Ans-B (Dysphoria is anxiety and ill ease) In addition to pain relief, codeine is also frequently used as a: a. Cough suppressant b. Decongestant c. Laxative d. Sedative - Correct Ans-A J. L., a 35-year-old anthropologist, started a selective serotonin reuptake inhibitor one month ago. He states, "I don't have a desire for sex anymore." He asks whether he has to live with this, or is there is anything that can be done? You respond: NSG 6020 a. "Continue the drug and the decreased libido will improve as the depression lifts." b. "Stop taking the drug immediately and call the prescriber." c. "Call the prescriber and ask whether Wellbutrin or Viagra may be used to improve your sex drive." - Correct Ans-C J.G., a 54-year-old engineer, is being started on a selective serotonin reuptake inhibitor. You counsel him that initially, the following symptoms may transiently occur: a. Loose stools and nausea b. Constipation and weight gain c. Watery eyes and drooling - Correct Ans-B J.L., a 20-year-old college student, has just started lithium. What dietary advice would you give? a. Restrict your sodium intake. b. Drink only 1000cc of fluids per day. c. Eat high-caloric foods. d. Replace sodium losses if sick with vomiting or diarrhea. - Correct Ans-D K. N., a 42-year-old housewife, has been admitted to the ICU with an overdose of a tricyclic antidepressant. She will need to be closely monitored for: a. hypertension b. fluid overload c. hypothermia d. cardiac arrhythmias - Correct Ans-D Levothyroxine is synthetic: a. TRH b. TSH c. T3 d. T4 - Correct Ans-D Liothyronine is synthetic: a. TRH b. TSH c. T3 d. T4 - Correct Ans-C Low-dose Iodine is used to: NSG 6020 NSG 6020 a. Treat thyroid cancer b. Treat hypothyroidism c. Destroy thyroid tissue d. Prevent Grave's disease - Correct Ans-C MAOIs are typically which line of defense to prescribe for ATYPICAL depression? a. 1st line b. 2nd line c. 3rd line d. 4th line - Correct Ans-A Meperidine (Demerol) dosing is restricted by which of the following? a. Long half-life b. Ease of crossing the blood-brain barrier c. Accumulation of a toxic metabolite d. Small first-pass mechanism - Correct Ans-C Meperidine (Demerol) may interact with a variety of antidepressants because it increases what neurotransmitter? a. Dopamine b. Serotonin c. Epinephrine d. Norepinephrine - Correct Ans-B Morphine blocks receptors at what areas in the body? a. Brain and spinal cord b. Bladder and ureters c. Liver and kidneys d. Stomach and small intestines - Correct Ans-A Morphine works best for what type of pain? a. Sharp and shooting b. Constant and dull c. Acute and mild d. Itching and burning - Correct Ans-B Most antagonists attach to what receptors? a. Mu b. Kappa c. Delta NSG 6020 NSG 6020 NSG 6020 d. Gamma - Correct Ans-A Most mixed agonists and antagonists are agonists at what receptor? a. Mu b. Kappa c. Delta d. Gamma - Correct Ans-B One month after your patient started taking levothyroxine for their hypothyroidism, a TSH test is ordered to test the function of the medication. Which of the following results would indicate that the thyroid hormone replacement is working? a. The TSH level is dropping or in normal range. b. The TSH level is elevating. c. The TSH level has remained the same. d. The TRH level is elevating. - Correct Ans-A Patients more likely to have hypersensitivity reactions to aspirin include those with: a. bleeding disorders and peptic ulcer disease. b. asthma and nasal polyps. c. renal insufficiency and liver disease. d. chicken pox and influenza. - Correct Ans-B Patients that need a larger dose needed for the same drug response has no tolerance with what symptoms? a. Diarrhea and nausea b. Constipation and pinpoint pupils c. Analgesia and respiratory depression d. Euphoria and sedation - Correct Ans-B S.M., an 80-year-old woman, has been taking alprazolam (Xanax) to shorten sleep onset at bedtime for 3 years. You are concerned that abrupt discontinuation of Xanax may cause: a. seizures. b. hypertension. c. paradoxical effects. d. retrograde amnesia. - Correct Ans-A S.S., a 21-year-old college student, states she has been having crying spells, insomnia, and difficulty getting dressed to go to school or visit friends. Upon questioning, she admits to suicidal ideation without a definite plan. A prescriber would want to avoid which antidepressant? NSG 6020 a. Selective serotonin reuptake inhibitor b. Tricyclic antidepressant c. Atypical antidepressant - Correct Ans-B Salicylism is a form of mild aspirin toxicity with symptoms such as: a. GI distress, diarrhea, and respiratory depression b. Headache, hypervigilance, and confusion c. Headache, tinnitus, sweating, dizziness d. Respiratory stimulation, constipation, and GI distress - Correct Ans-C Stimulation of which receptors can result in severe respiratory depression and physical dependence? a. Mu receptors b. Kappa receptors c. Delta receptors d. Gamma receptors - Correct Ans-A T.S., a 35-year-old truck driver, states that he is being treated for depression. He does not remember the name of the antidepressant, but states he is not allowed to eat aged cheeses, chocolate, or drink wine. You suspect he is taking a(n): a. Selective serotonin reuptake inhibitor b. Tricyclic antidepressant c. Monoamine oxidase inhibitor d. Atypical antidepressant - Correct Ans-C The COX-1 enzyme is responsible for all of the following EXCEPT: a. Gastric protection b. Mucus secretion c. Maintenance of renal function d. Platelet aggregation - Correct Ans-B The COX-1 enzyme may cause what two health conditions due it's ability to increase platelet aggregation? a. Kidney failure and urinary tract infection b. Gastric ulcers and h. pylori infection c. High blood pressure and tachycardia d. MI and stroke - Correct Ans-D NSG 6020 NSG 6020 NSG 6020 The nurse in the emergency department is caring for a patient with a suspected overdose of diazepam (Valium). Which agent is likely to be given to reverse the effects of diazepam? a. Naloxone (Narcan) b. Flumazenil (Romazicon) c. Acetylcysteine d. Vitamin K - Correct Ans-B (Flumazenil, a benzodiazepine receptor antagonist, is the treatment of choice for benzodiazepine overdose. Naloxone is used to reverse opioid overdose, acetylcysteine is used to reverse acetaminophen overdose, and vitamin K is used to reverse warfarin toxicity) The nurse is caring for a female patient receiving sumatriptan (Imitrex). Which of the following guides the nursing care of this patient? a. Coronary vasospasm is a common problem with this drug. b. Many patients experience symptoms of chest pressure or heavy arms. c. This drug increases the risk for nausea and vomiting with migraines. d. This drug is considered safe to use during pregnancy. - Correct Ans-B (About 50% of patents have chest symptoms including a feeling of "heavy arms" or chest pressure. These symptoms will subside and do not indicate cardiac ischemia. Coronary vasospasm can occur, but is rare. Patients with coronary artery disease should avoid sumatriptan. Sumatriptan not only relieves headaches, but also relieves other migraine associated symptoms, such as photophobia, nausea, and phonophobia. Sumatriptan can cause harm to the developing fetus and should be avoided in pregnancy. It is classified as Pregnancy Risk Category C.) The nurse is caring for a group of patients being treated for depression. Why might an SSRI be chosen over a TCA? a. To decrease the risk of suicide with overdose b. To avoid weight gain and other GI effects c. To help prevent sexual dysfunction d. To prevent the risk of serotonin syndrome - Correct Ans-A The nurse is caring for a patient receiving buspirone (BuSpar) for the treatment of anxiety. Which symptom below is most likely explained as an adverse effect of this drug? a. Drowsiness b. Risk for abuse c. Dizziness d. Weight gain - Correct Ans-C (Buspirone is an antianxiety medication with few side effects. The most common effects are dizziness, nausea, headache, nervousness, lightheadedness, and excitement. It does not cause drowsiness, risk for abuse, or weight gain.) NSG 6020 NSG 6020 The nurse is caring for a patient receiving fluoxetine (Prozac) for depression. Which adverse effect below is most likely associated with this drug? a. Sexual dysfunction b. Dry mouth c. Orthostatic hypotension d. Bradycardia - Correct Ans-A The nurse is caring for a patient receiving lithium (Lithobid). The nurse understands that there are many drug interactions with lithium. Which agent is safe to give with lithium? a. Ibuprofen (Motrin) for muscle pain b. Hydrochlorothiazide (HCTZ) for edema c. Aspirin (ASA) for mild headache d. Diphenhydramine (Benadryl) for cold symptoms - Correct Ans-C (Aspirin is safe to use as an analgesic with lithium. Other NSAIDs, such as ibuprofen, can increase lithium levels by as much as 60%. Diuretics increase lithium levels by decreasing serum sodium levels. Diphenhydramine has anticholinergic properties and can aggravate lithium-induced polyuria by causing urinary hesitancy.) The nurse is caring for a patient taking buspirone (BuSpar). Which statement made by the patient indicates a need for further teaching about this drug? a. " This medication should not make me feel drowsy." b. " This medication should help me feel less anxious." c. "I will drink grapefruit juice instead of coffee with breakfast." d. " I will take my medication three times per day." - Correct Ans-C (Grapefruit juice can greatly increase buspirone levels and should not be taken. The other statements are appropriate. The initial dosing for buspirone is 5 mg three times daily.) The nurse is caring for a patient with a seizure disorder who takes mephobarbital (Mebaral) at bedtime each night to control seizures. Which symptom below, if present, would most likely indicate an adverse effect of this drug? a. Morning sedation b. Respiratory rate = 30 breaths per minute c. Constipation d. Blood pressure = 160/88 mm Hg - Correct Ans-A (The adverse effects of the barbiturates include respiratory depression, risk for suicide, risk for abuse, and hangover (sedation, impaired judgment, reduced motor skills).) The nurse is caring for a patient with bipolar disorder (BPD) who is taking lithium (Lithobid). Which abnormal lab value below is the most essential for the nurse to communicate to the healthcare provider, because this patient is receiving lithium? NSG 6020 NSG 6020 a. Sodium = 128 mEq/L b. Prothrombin time = 8 seconds c. Blood urea nitrogen = 25 mg/dL d. Potassium = 5.6 mEq/L - Correct Ans-A The nurse is seeing each of the patients below in the outpatient clinic today. Which patient requires the most immediate attention by the nurse? a. A female with bipolar disorder receiving valproic acid (Depakene) who reports nausea and vomiting b. A male with bipolar disorder receiving lithium, with a lithium level of 1.6 mEq/L c. A male with depression receiving fluoxetine (Prozac), with reports of sexual dysfunction d. A female with schizophrenia receiving haloperidol (Haldol), with blood pressure of 102/72 - Correct Ans-B The nurse is teaching a patient about a new prescription for alprazolam (Xanax). Which statement is the most appropriate to include in the teaching plan? a. " When it is time to discontinue this drug, you will need to taper off of it slowly." b. " Protect your skin from the sun to avoid rash and exaggerated sunburn." c. " Increase your intake of fluid and high-fiber foods to avoid constipation." d. " Take this medication on an empty stomach at least 2 hours after meals." - Correct Ans-A (Alprazolam is a benzodiazepine that can precipitate withdrawal symptoms if abruptly discontinued. Patients should withdraw the drug gradually over several weeks. The other statements are not related to alprazolam.) The nurse is teaching a patient about a new prescription for citalopram (Celexa). Which statement is appropriate to include in the teaching plan? Select all that apply. a. " This medication may cause some sexual side effects. Let your healthcare provider know about this if it occurs." b. " When you stop taking this medication, you should not withdraw it abruptly." c. " You will need to move slowly from a sitting to standing position to avoid dizziness from low blood pressure." d. " This medication often causes drowsiness. You should take it at bedtime." e. "Let your family or your healthcare provider know if you experience a worsening mood, agitation, or increased anxiety." - Correct Ans-A B E (Citalopram and other SSRIs can cause sexual side effects that patients may be hesitant to report. They should be withdrawn slowly to avoid dizziness, headache, dysphoria, and/or other symptoms of withdrawal. The SSRIs do not generally cause orthostatic hypotension or drowsiness. All antidepressants initially increase the risk of suicide, and patients should be monitored for worsening mood and other signs of suicide risk.) The physician has ordered Stadol (an agonist-antagonist opioid) to be given in combination with morphine for moderate postoperative pain. You administer the NSG 6020 NSG 6020 medication and check on the patient 30 minutes later to see that they are experiencing withdrawal symptoms and a great deal of pain. What most likely happened in this situation? a. The morphine knocked the Stadol off of the mu receptors to precipitate the pain and withdrawal symptoms b. The Stadol knocked the morphine off the mu receptors to cause these symptoms c. An allergic reaction occurred in this patient d. The two medications reacted to form a precipitate in the patient's bloodstream, causing these symptoms - Correct Ans-B The time it takes methimazole (Tapazole) to induce lower T4 levels to normal is: a. 3 to 6 minutes b. 24 hours c. 1 to 2 days d. 3 to 12 weeks - Correct Ans-D Thyroid replacement is contraindicated in patients with what condition? a. Type II diabetes b. MI and thyrotoxicosis c. Hypothyroidism d. Pregnancy - Correct Ans-B To test for a thyroid disorder, which of the following tests would MOST likely be ordered? a. Serum T3 b. Serum T4 c. TSH d. Creatinine - Correct Ans-C Tricyclic antidepressants, which have a sedation effect, may be used for all of the following conditions EXCEPT: a. Fibromyalgia b. Crohn's disease c. Neuropathic pain d. Migraines e. Insomnia - Correct Ans-B What antidepressant interacts with Demerol to increase serotonin to dangerous levels, possibly results in severe respiratory depression, coma, or death? a. SSRIs NSG 6020 b. SNRIs c. MAOIs d. Naran - Correct Ans-C What are the three symptoms in the classic triad of opioid toxicity? a. Nausea, vomiting, diarrhea b. Respiratory depression, insomnia, irritability c. Coma, respiratory depression, miosis (pinpoint pupils) d. Euphoria, dysphoria, and sedation - Correct Ans-C What is a side effect of opioids relating to the cardiovascular system? a. Myocardial infarction b. Hypertension c. Orthostatic hypotension d. Heart failure - Correct Ans-C What is an opiate? a. Any drug that only has compounds present in opium, such as morphine or codeine b. Any drug that has a similar action to morphine c. Any nonsteroidal anti-inflammatory drug - Correct Ans-A What is an opioid? a. Any drug that only has compounds present in opium, such as morphine or codeine b. Any drug that has a similar action to morphine c. Any nonsteroidal anti-inflammatory drug - Correct Ans-B What is the drug of choice to treat hypothyroidism? a. Methimazole b. Levothyroxine c. Liothyronine d. Propylthiouracil - Correct Ans-B What is the interaction between catecholamines and levothyroxine? a. Levothyroxine has no effect on the bodies response to catecholamines. b. Lexothyroxine decreases the bodies response to catecholamines. c. Lexothyroxine increases the bodies response to catecholamines. - Correct Ans-C What is the most common opioid antagonist to give in patients where reversal is needed? NSG 6020 NSG 6020 NSG 6020 a. Stadol b. Metropolol c. Pentazocine d. Narcan - Correct Ans-D What is the preferred drug of use for hyperthyroidism? a. Methimazole b. Propylthiouracil c. Levothyroxine d. Beta-blockers - Correct Ans-A What is the rationale for administering antipsychotics during manic episodes? a. They help control symptoms during severe manic episodes. b. They help elevate mood during manic episodes. c. They are given for their sedating effects during manic episodes. d. They are given in the presence of psychotic episodes. - Correct Ans-A (Antipsychotic drugs are given to help control symptoms during severe manic episodes, even if psychotic symptoms are absent. Benzodiazepines are given for their sedating effects. Antidepressants help elevate mood during manic episodes.) What is the toxic metabolite for Meperidine? a. Demerol b. Normeperidine c. Dormeperidine d. Monoamine oxidase - Correct Ans-B What lab values are expected for a patient with Grave's disease? a. Decreased T3 and T4 b. Elevated T3 and T4 c. Elevated TSH - Correct Ans-B When educating your patient about taking levothyroxine with drugs that reduce absorption in the stomach, which of the following statements would you tell them? a. "You can take levothyroxine and proton pump inhibitors at the same time during breakfast." b. "You should wait two hours between taking levothyroxine and drugs that reduce absorption in the stomach." c. "You should wait at least four hours between taking levothyroxine and drugs that reduce absorption in the stomach." d. "Never take levothyroxine and drugs that reduce absorption in the stomach less than 24 hours apart." - Correct Ans-C NSG 6020 Which agent below is most likely to be prescribed today for treatment of the short-term management of insomnia? a. Secobarbital (Seconal Sodium) b. Meprobamate (Miltown) c. Zolpidem (Ambien) d. Flumazenil (Romazicon) - Correct Ans-C (Zolpidem is a benzodiazepine-like drug widely used today for the treatment of insomnia. It is safer than the barbiturates (secobarbital) or miscellaneous sedative-hypnotics (meprobamate). Flumazenil is a reversal agent for the benzodiazepines.) Which antianxiety agent is used to prevent CNS depression? a. Lorazepam (Ativan) b. Phenobarbital c. Buspirone (BuSpar) d. Diphenhydramine (Benadryl) - Correct Ans-C Which drug may precipitate pain or withdrawal when used with morphine? a. Meperidine (Demerol) b. Pentazocine (Talwin) c. Codeine d. Hydrocodone (Lortab) - Correct Ans-B Which drug would be the best choice for treating chronic repeated awakenings from sleep? a. Lorazepam (Ativan) b. Zaleplon (Sonata) c. Eszoplicone (Lunesta) d. Ramelteon (Rozerem) - Correct Ans-C Which drugs interact with opioids to decrease nausea? a. Dextromethorphan b. Amphetamines c. Antiemetics d. Antihistamines - Correct Ans-C Which NSAID irreversibly inhibits platelet aggregation? a. naproxen (Aleve) b. ibuprofen (Motrin) c. celecoxib (Celebrex) NSG 6020 NSG 6020 d. acetylsalicylic acid (Aspirin) - Correct Ans-D Which of the following adverse effects is common with centrally acting muscle relaxants? a. Nausea and vomiting b. Hyperpyrexia c. Sedation d. Hypertension - Correct Ans-C Which of the following adverse effects would you expect to see in a patient taking propylthiouracil? a. Severe kidney injury b. Agranulocytosis c. Hyperthyroidism d. Hypoglycemia - Correct Ans-B Which of the following antagonists is used for acute toxicity in patients taking benzodiazepines intravenously? a. Naloxone (Narcan) b. Flumazenil (Romazicon) c. Acetaminophen (Tylenol) d. Naproxin (Aleve) - Correct Ans-B Which of the following antidepressants are first-line drugs? (Select all that apply). a. Tricyclic antidepressants (TCAs) b. SSRIs and SNRIs c. Buproprion (Wellbutrin) d. Mirtazapine (Remeron) e. Monoamine oxidase inhibitors (MAOIs) - Correct Ans-B C D Which of the following antidepressants have food restrictions? a. Selective serotonin- norepinephrine reuptake inhibitors (SNRIs) b. Monoamine oxidase inhibitors (MAOIs) c. Mirtazapine (Remeron) d. Tricyclic antidepressants (TCAs) - Correct Ans-B Which of the following antidepressants is most likely going to be given FIRST in depression? a. Selective serotonin reuptake inhibitors (SSRIs) b. Monoamine oxidase inhibitors (MAOIs) NSG 6020 NSG 6020 NSG 6020 c. Mirtazapine (Remeron) d. Tricyclic antidepressants (TCAs) - Correct Ans-A Which of the following antidepressants would most likely be used for a nicotine addiction? a. One that increases serotonin b. One that increases norepinephrine c. One that increases dopamine d. One that blocks dopamine - Correct Ans-C Which of the following are INITIAL signs and symptoms of salicylate poisoning? a. Respiratory alkalosis and metabolic alkalosis b. Respiratory alkalosis and metabolic acidosis c. Respiratory acidosis and metabolic alkalosis d. Respiratory acidosis and metabolic acidosis - Correct Ans-B Which of the following are some advantages with taking the mood-stabilizing anticonvulsant divalproex sodium (valproate)? a. It supplements a fetus folic acid b. It has a faster onset, has fewer side effects, and a higher therapeutic index than lithium c. It has a long half-life d. It is safe to use in pregnancy and lactation - Correct Ans-B Which of the following barbiturates would most likely be used for inducing general anesthesia? a. Secobarbital b. Methohexital c. Phenobarbital d. Lorazepam (Ativan) - Correct Ans-B Which of the following benzodiazepines has an effect on REM sleep? a. Zolpidem (Ambien) b. Alprazolam (Xanax) c. Eczoplicone (Lunesta) d. Trazodone (Desyrel) - Correct Ans-B Which of the following benzodiazepines would most likely be used to shorten sleep onset and awakenings and increase sleep duration? a. Zolpidem (Ambien) NSG 6020 b. Alprazolam (Xanax) c. Buspirone (BuSpar) d. Diphenhydramine (Benadryl) - Correct Ans-A Which of the following birth defects would NOT be seen in a neonate who's mother took opioids during the first trimester? a. Mental retardation b. Heart defects c. Spina bifida d. Gastrochisis - Correct Ans-A Which of the following drug categories is commonly used as a mood stabilizer for bipolar disorder? a. Antidepressants b. Barbiturates c. Glucocorticoids d. Lithium - Correct Ans-D Which of the following drug categories is most effective at prevent suicide and addiction relapse? a. Lithium b. Barbiturates c. Glucocorticoids d. Antidepressants - Correct Ans-A Which of the following drugs interacts with opioids to decrease sedation and make the patient more awake? a. Antiemetics b. Alcohol c. Antidepressants d. Amphetamines - Correct Ans-D Which of the following drugs is the most dangerous with overdose? a. Opioids b. Benzodiazepines c. Benzodiazepine-Like Drugs d. Barbiturates - Correct Ans-D (They can be absolutely lethal.) Which of the following drugs would be safe to take with a tricyclic antidepressant? a. Antihistamines NSG 6020 NSG 6020 b. CNS depressants c. Aspirin d. MAOIs - Correct Ans-C Which of the following drugs would NOT increase analgesia when taken with an opioid? a. Amphetamines b. Antiemetics c. Clonidine d. Dextomethrophan - Correct Ans-B Which of the following drugs would NOT interact with bupropion? a. Drugs that increase dopamine, such as MAOIs b. Drugs that increase serotonin, such as SSRIs c. Drugs that lower the seizure threshold, such as glucocorticoids d. Drugs that inhibit the CYP2B6 enzyme, such as Zoloft - Correct Ans-B Which of the following electrolytes is EXTREMELY important to keep at a stable/higher level to prevent the body from retaining the medication? a. Magnesium b. Aluminum c. Sodium d. Chloride - Correct Ans-C Which of the following foods contains tyramine? (Select all that apply). a. Cheddar cheese b. Milk c. Edamame d. Smoked salmon e. Apples f. Bananas - Correct Ans-A C D F Which of the following groups of symptoms are the MOST common adverse effects seen in patients taking a tricyclic antidepressant? a. Sedation, anticholinergic effects, orthostatic hypotension b. Sweating, weight loss, increased libido c. Dysrhythmias, bradycardia, atrial fibrillation d. Nausea, vomiting, diarrhea - Correct Ans-A Which of the following groups of symptoms would most likely be seen in a patient taking an SNRI? NSG 6020 NSG 6020 NSG 6020 a. Sedation, constipation, hypothermia b. Coma, miosis, respiratory depression c. Nervousness, insomnia, vertigo d. CNS stimulation, insomnia, sexual dysfunction, weight gain - Correct Ans-C Which of the following groups of symptoms would most likely be seen in a patient taking an SSRI? a. Sedation, constipation, hypothermia b. Hypernatremia, hypoglycemia, increased blood clots c. Weight loss, lack of appetite, hypertension d. CNS stimulation, insomnia, sexual dysfunction, weight gain - Correct Ans-D Which of the following is considered a disadvantage of taking BuSpar? a. It has no sedation or abuse potential b. It treats anxiety only c. It binds to a low amount of dopamine receptors d. It does not enhance CNS depression or have cross tolerance with benzodiazepines, barbiturates, and opioids - Correct Ans-B Which of the following is correct about the atypical antidepressant, Bupropion (Wellbutrin, Zyban, others)? a. It is commonly used for weight gain and anxiety b. It is commonly used to suppress appetite and increase sexual desire c. It is not used for addiction cessation because it only reuptakes epinephrine. d. It's common side effects include: nausea, vomiting, and diarrhea - Correct Ans-B Which of the following is NOT a contraindication for taking benzodiazepines? a. Respiratory depression b. Congestive heart failure c. Pregnancy and lactation d. Obstructive sleep apnea - Correct Ans-B Which of the following is NOT a precaution for opioids? a. Labor and delivery b. Inflammatory bowel disease c. Head injury d. Hypertension e. Liver disease - Correct Ans-D Which of the following is NOT a principal action of thyroid hormones? NSG 6020 NSG 6020 a. Stimulation of energy use by increasing basal metabolism rate b. Delivers oxygen to peripheral tissues c. Stimulate the heart and increase heart rate and force of contraction d. Promotion of growth and development - Correct Ans-B Which of the following is NOT a side effect of morphine? a. Miosis b. Orthostatic hypotension c. Histamine release d. Urinary frequency - Correct Ans-D (Urinary retention would occur when taking opioids) Which of the following is NOT a use for centrally acting muscle relaxants? a. Relieve localized muscle spasms b. Decreasing inflammation c. Decrease pain d. Increase range of motion - Correct Ans-B Which of the following is NOT an adverse effect seen in patients who take mirtazapine (Remeron)? a. Constipation b. Somnolence c. Weight gain d. Increased appetite - Correct Ans-A Which of the following is NOT an adverse effect seen with benzodiazepines? a. Hypertension b. Daytime sedation b. Anterograde amnesia d. Anxiety, rage - Correct Ans-A Which of the following is the correct order steps for thyroid hormone regulation? a. The TRH is released from the hypothalamus and stimulates the release of T3 and T4 from the anterior pituitary, which stimulates TSH from the thyroid to produce biologic effects b. TSH is released from the hypothalamus and stimulates the release of TRH from the anterior pituitary which stimulates T3 and T4 from the thyroid to produce biologic effects c. TRH is released from the hypothalamus and stimulates the release of TSH from the anterior pituitary, which stimulates T3 and T4 from the thyroid to produce biologic effects NSG 6020 NSG 6020 d. T3 and T4 are released from the hypothalamus to stimulate the release of TRH from the anterior pituitary, which stimulates TSH from the thyroid to produce biologic effects - Correct Ans-C (TRH from hypothalamus. TSH from anterior pituitary. T3 & T4 from thyroid inhibit TSH from anterior pituitary) Which of the following may indicate a potentially dangerous, rare adverse effect of thionamides? a. Headache b. Paresthesias c. Rash d. Sore throat - Correct Ans-D (Sore throat indicates agranulocytosis) Which of the following medications may need to be reduced when taking levothyroxine due to the increase of the chance of bleeding? a. Warfarin b. Omeprazole c. Cimetidine d. Questran - Correct Ans-A Which of the following medications would be considered safe to take with a benzodiazepine? a. Alcohol b. Benadryl c. Morphine d. Omeprazole - Correct Ans-D (Alcohol, benadryl, and morphine are all CNS depressants that interact with benzodiazepines. Taking these medications with benzodiazepine may lead to respiratory depression, altered LOC and coma, and possibly death. Omeprazole is a proton pump inhibitor that is not a CNS depressant and is used for issues with gastric acid.) Which of the following medications would most likely be used for anxiety, insomnia, and seizures? a. Benzodiazepines b. Opiates c. Antidepressants d. Opioids - Correct Ans-A Which of the following patient populations would NOT be contraindicated to take opioids? a. A pregnant woman in her first trimester b. A 42-year-old female with type I diabetes NSG 6020 NSG 6020 c. A 54-year-old male with inflammatory bowel disease d. A 63-year-old male with benign prostatic hypertrophy - Correct Ans-B (A pregnant woman should not take opioids at conception or within the first trimester due to possible birth defects. Someone with IBD may develop a toxic mega colon or paralytic ileus when taking opioids. Someone with BPH may have urinary retention already and opioids would cause more urinary retention which would be contraindicated. A patient who has type I diabetes would not be contraindicated because they are most likely not extremely obese since it is type I and not type II.) Which of the following patient's would be most likely to have a developed tolerance for benzodiazepines? a. A patient who was given morphine once for extraction of a tooth b. A patient who has four drinks of alcohol per day and has been drinking for 20 years c. A patient who takes benzodiazepines for anti-anxiety effects d. A patient who takes Benadryl to help them sleep when they have a cold - Correct Ans-B Which of the following populations would be LEAST likely to have hypersensitivity to salicylates? a. A 20-year-old female with chronic asthma b. A 35-year-old female with allergic rhinitis, meaning they may be allergic to things like dust, animal dander, or pollen c. An 8-year-old child with type I diabetes d. A 42-year-old male with nasal polyps - Correct Ans-C Which of the following populations would be safe to take salicylates? a. Smokers taking glucocorticoids b. Athletes c. Alcoholics d. Elderly - Correct Ans-B Which of the following side effects of morphine (Duramorph) does NOT subside over time? a. Constipation b. Sedation c. Respiratory depression d. Nausea and vomiting - Correct Ans-A Which of the following signs and symptoms in a patient taking opioids would indicate a possibility of impending respiratory depression? a. Inability to converse coherently NSG 6020 NSG 6020 b. Nausea and vomiting c. Imbalance d. Constipation - Correct Ans-A Which of the following statements is true regarding antidepressants? a. 1-3 weeks is required for them to take their effect b. A patient taking antidepressants should take it for 12 months after symptoms subside c. They increase the risk of suicide in patients older than 25 years of age d. They are the only known treatment for depression - Correct Ans-A Which of the following statements made by a patient taking a MAOI indicates further teaching? a. "I should eat a diet high in fruits and vegetables such as bananas, avocado, and figs to increase absorption of this medication." b. "I should avoid milk products such as aged sharp cheddar while taking this medication to prevent hypertensive crisis." c. "I should stand up and change positions slowly while taking a MAOI." d. "I will not take another antidepressant with this medication, such as an SSRI, to prevent serotonin syndrome." - Correct Ans-A Which of the following statements said by a patient being prescribed an opioid for the first time requires further instruction? a. "I will double check each dosage with another person." b. "I will monitor my pain before and one hour after I take my opioid." c. "I will taper my doses after prolonged use." d. "I will stop taking my opioid if a friend or family member notices that my respiratory rate is less than 8/min, I have a significant rise in blood pressure, or a significant elevation or drop in pulse." - Correct Ans-D (Hold opioid if respiratory rate 12/min, significant drop in BP, or significant elevation or drop in pulse.) Which of the following would NOT be an anticipated result of a mother taking opioids for an extended period of time while pregnant? a. Cause preterm labor b. Suppressed uterine contractions c. Neonate has physical dependence of opioids d. Respiratory depression in the neonate - Correct Ans-A Which of the following would NOT interact with levothyroxine? a. H2 receptor blockers and proton pump inhibitors b. Bile-acid sequetrants c. Vitamins NSG 6020 NSG 6020 d. An empty stomach - Correct Ans-D Which of the following would NOT interact with opioids to increase constipation and urinary retention? a. Antiemetics b. Antihistamines c. Antidepressants d. Atropine - Correct Ans-A Which of the following would NOT interact with opioids to increase sedation? a. Sedative b. Amphetamines c. Alcohol d. Barbiturates - Correct Ans-B Which of these findings in a patient who is taking ibuprofen (Advil) should a nurse report to the prescriber? a. Hives b. Hematemesis c. Dysmenorrhea d. Jaundice - Correct Ans-B (Ibuprofen is a member of the nonaspirin first-generation nonsteroidal anti-inflammatory drugs (NSAIDs). Through inhibition of both cyclooxygenase-1 (COX-1) and cyclooxygenase-1 (COX-2), ibuprofen poses a risk for gastric ulceration and bleeding, which may lead to hematemesis. It is used to reduce inflammation, fever, and pain, and thus is effective in reducing dysmenorrhea (painful menstrual cramping). It is not known to cause hives or jaundice, which are signs of impaired lever function.) Which of these findings, if noted in a patient who is taking levothyroxine (Synthroid) and warfarin (Coumadin), would require follow-up by a nurse? a. Cardiac dysrhythmias b. Excessive bruising c. Weight loss of 5 kg d. Shortness of breath - Correct Ans-B (Levothyroxine intensifies the effect of warfarin, an anticoagulant that increases the patient's risk for bleeding, by degrading vitamin K dependent clotting factors more quickly. The warfarin dose may need to be decreased. Bruising, weight loss, and shortness of breath are not effects associated with interactions of levothyroxine and warfarin.) Which of these manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine (Synthroid)? NSG 6020 NSG 6020 a. Tachycardia b. Tremors c. Insomnia d. Irritability - Correct Ans-A (High doses of levothyroxine may cause thyrotoxicosis, a condition of profound excess thyroid activity. Tachycardia is the priority assessment, because it can lead to severe cardiac dysfunction. Tremors, insomnia, and irritability are other symptoms of thyrotoxicosis and should be assessed after tachycardia.) Which of these statements is the most important for a nurse to make to a patient who is taking propylthiouracil (PTU)? a. "You need to notify your doctor if you have a sore throat and fever." b. " Another medication can be given if you experience any nausea." c. " You may experience some muscle soreness with this medicine." d. " Headache and dizziness may occur but not very frequently." - Correct Ans-A (Agranulocytosis (the absence of granulocytes to fight infection) is the most serious toxicity associated with propylthiouracil. Sore throat and fever may be the earliest signs. Nausea, muscle soreness, and headache and dizziness are other adverse effects of propylthiouracil that are not as serious as agranulocytosis.) Which receptors are stimulated by opioid analgesics? a. Mu receptors only b. Kappa receptors only c. Delta receptors only d. Mu and kappa receptors - Correct Ans-D You are changing your postoperative patient from an intravenous to an oral form of opioid. You expect the dosage to: a. decrease. b. stay the same. c. increase. - Correct Ans-C You are implementing patient education for a client who has just started taking levothyroxine (Synthroid) for their hypothyroidism. Which of the following statements made by the client requires further instruction? a. "I should only use one brand and use the same one every time when taking this medication because not every brand has the identical effect." b. "This medication should only take a week for an effect to take place." c. "I should recheck my thyroid hormone levels one month after beginning levothyroxine." d. "I should take this medication 30-60 minutes before breakfast." - Correct Ans-B (Levothyroxine takes 1 month to reach plateau) NSG 6020 NSG 6020 You are teaching a client information about taking barbiturates. Which of the following statements made by the patient indicates further instruction? a. "I will make sure to not stop taking my dose abruptly since I should be monitored by a physician during withdrawal." b. "I will avoid activities requiring mental alertness until my tolerance develops." c. "I am at risk for respiratory depression while taking this medication, so I will make sure to have someone monitor my respirations regularly, including BP and pulse." d. "It is safe to take alcohol, benzodiazepines, opioids, other CNS depressants, and antihistamines while taking this medication." - Correct Ans-D You are teaching a patient information to know about benzodiazepines. Which of the following statements made by the patient requires further instruction? a. "I will monitor my respirations, blood pressure and pulse. If my pulse is slowing down or speeding up, I will call the physician." b. "I will not use this medication for minor stressors of everyday life, and only for acute situations." c. "I am safe to drive while under the influence of this medication." d. "I should not take this medication with, alcohol, opioids, and other central nervous system depressants as well as antihistamines." e. "I will make sure not to crush my sustained-release formulations." - Correct Ans-C You are teaching your patient about the bleeding effects of taking aspirin. Which of the following statements made by your patient shows that your education is working? a. "It is safe to take this medication before I go into labor or have a major surgery." b. "I should stop taking aspirin before my dental surgery next week." c. "I will monitor my blood pressure and try to keep it below 150/90 to reduce my risk of hemorrhagic stroke." d. "I should take blood thinners while taking aspirin." - Correct Ans-C You are teaching your patient about the gastrointestinal effects of salicylates. Which of the following statements from your patient requires further instruction? a. "It is safe to smoke while taking this medication." b. "I should avoid alcohol to prevent the formation of gastric ulcers." c. "I should take this medication with food and a full glass of water or milk." d. "I should be careful with using my asthma inhaler while taking this medication." - Correct Ans-A You are teaching your patient being prescribed a tricyclic antidepressant important information to know about taking this medication. Which of the following statements made by the patient indicates the teaching has been successful? a. "I will see an effect in 1-3 weeks." NSG 6020 NSG 6020 b. "It is safe for me to drive while taking this medication." c. "I'm going to take my dose in the morning so I will have energy for the day." d. "I can stop taking this medication once by symptoms of depression have subsided." - Correct Ans-A You are teaching your patient information about taking lithium. Which of the following statements made by the patient indicates the need for further instruction? a. "I will limit my intake of fluids to prevent polyuria." b. "I will take lithium with milk or food to prevent GI upset." c. "I will limit my calorie intake to reduce weight gain." d. "I will avoid pregnancy and lactation while taking this medication because it is toxic to the fetus." e. "I may be able to take a thyroid hormone to prevent hypothyroidism while taking this medication." - Correct Ans-A You may see all of the following in an infant with congenital hypothyroidism EXCEPT: a. Mental retardation b. Exophthalmus c. Large tongue and pot belly d. Dwarfish stature and derangement of growth - Correct Ans-B Your 55-year-old patient has a fractured rib. She is being released from the emergency room with a prescription for a narcotic analgesic. Before discharging this patient, you assess the patient's lifestyle, diet, and habits. Which of the following questions should be included in this assessment? a. Are you able to drink 3 liters of water a day? b. Do you drink alcoholic beverages? c. Do you lift weights daily? d. Do you eat calcium-containing foods? - Correct Ans-B Your 68-year-old patient is being treated with levothyroxine 50 mcg/day. She states that the room's thermostat is set too high. She is sweating and has a noticeable fine tremor as she lifts a glass. You suspect that she is showing signs of: a. myxedema. b. Graves' disease. c. cretinism. d. thyrotoxicosis. - Correct Ans-D Your patient has been taking opioids for an extended amount of time due to their chronic pain, and now need a larger dose needed for the same therapeutic response. What patient education would you give to this patient in anticipation that they will develop no tolerance to some symptoms these medications may cause? NSG 6020 NSG 6020 a. "Make sure to take this on an empty stomach and limit your fluid intake to 1000 mL per day." b. "It is important to call your doctor if a friend reports that your respirations are less an 10 per minute." c. "It is important to drink plenty of fluids and possibly take stool softeners. Also, make sure your bedroom is a safe environment at night to prevent falling and use a nightlight." - Correct Ans-C Your patient has received low dose radioactive Iodine (131). You counsel your patient by stating that the drug: a. prevents the synthesis and release of thyroid hormone. b. completely destroys the thyroid gland. c. may cause hypothyroidism over time. - Correct Ans-C Your patient in the emergency department arrived nonresponsive. The patient's friend states, "I don't know what he took an overdose of, but maybe oxycontin." You administer IV naloxone, and the patient awakens. What is the most essential nursing action for this patient? a. Contact psychiatry services for an admittance consultation. b. Administer sodium bicarbonate to keep the patient's blood pH normal. c. Draw a drug level. d. Frequently monitor the patient's level of consciousness. - Correct Ans-D Your patient is a 27-year-old female patient with hypothyroidism taking levothyroxine that is newly married. Which of the following statements would you say to your patient regarding pregnancy and her medication? a. "You should be careful about getting pregnant because levothyroxine is toxic to a fetus." b. "You should decrease your dosage by 50% once your pregnancy is confirmed." c. "Once your pregnancy is confirmed, increase your dosage of the medication by 50% percent." d. "Because fetuses are unable to produce thyroid hormones during the first trimester, make sure to increase your dosage by 30% as soon as your pregnancy is confirmed to reduce the risk of decreased IQ and neuropsychological function in the fetus." - Correct Ans-D Your patient is being given Demerol for shivering during labor. Which of the following group of symptoms are important to look for when monitoring for accumulation of normeperidine? a. Nausea, vomiting, diarrhea b. Angina, insomnia, tachycardia NSG 6020 NSG 6020 c. Agitation, tremors, seizures d. Constipation, hypotension, bradycardia - Correct Ans-C Your patient is experiencing symptoms indicating hypersensitivity to salicylates. They are having bronchospasm and laryngeal edema. What medication to you anticipate the provider will MOST LIKELY order to treat these symptoms in this patient? a. An anti-histamine b. Epinephrine c. A bronchodilator d. Norepinephrine - Correct Ans-B Your patient is taking a prescribed opioid and seems to be