NURS 180 / NURS180 Week 2 Quiz (Latest 2026/2027 Update) | Pharmacology | Verified Questions & Answers | 100% Correct Solutions | Grade A | WCU

NURS 180 / NURS180 Week 2 Quiz (Latest 2026/2027 Update) | Pharmacology | Verified Questions & Answers | 100% Correct Solutions | Grade A | WCU Q: A nurse is teaching a client who will begin taking aluminum hydroxide. Which of the following info should the nurse include in the teaching? A. If constipation develops, switch to a calcium-based antacid. B. Take this med 2 hours before or after other meds C. This med increases the risk for pneumonia D. Have your magnesium level monitored while taking this med B. Cimitedine alters the absorption of many meds Q: A nurse is teaching a client who has a new prescription for omeprazole. Which of the following info should the nurse include? A. Take this med at bedtime B. This med decreases the production of gastric acid C. Take this med 2 hours after eating D. This med can cause hyperkalemia. B Q: A nurse is teaching a client who takes phenytoin and has a new prescription for sucralfate tablets. Which of the following instructions should the nurse include? A. Take an antacid with the sucralfate B. Take sucralfate with a glass of milk C. Allow a 2 hr interval between these meds D. Chew the sucralfate thoroughly before swallowing C Q: A nurse is caring for 4 clients who have peptic ulcer disease. The nurse should identify misoprosotol is contraindicated for which of the following clients? A. A client who's pregnant B. A client with osteoarthritis C. A client who has a kidney stone D. A client with a UTI A Q: A nurse is teaching a client about cimetidine. Which of the following are adverse effects of cimitedine? (Select all that apply) A. Increased libido B. Insomnia C. Enlargement of breast tissue D. Confusion E. Decreased sperm count B, D, E Q: A nurse is caring for a client who received prochlorperazine 4 hours ago. The client reports spasms of the face. The nurse should expect a prescription for which of the following meds? A. Fomepizole B. Naloxene C. Phyntonadione D. Diphenhydramine D Q: A nurse is planning to administer ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply) A. Headache B. Diarrhea C. Shortened PR interval D. Hyperglycemia E. Prolonged QT interval A, B, E Q: A nurse is providing instructions about the use of laxatives to a client w heart failure. The nurse should tell the client to avoid which of the following laxatives? A. Sodium phosphate B. Psyllium C. Bisacodyl D. Polyethylene glycol A - absorption of this causes extra sodium thus causing fluid retention exacerbating heart failure Q: A nurse is caring for a client who has diabetes and is experiencing nausea and vomiting due to gastroparesis. The nurse should expect a prescription for which of the following meds? A. Lubiprostone B. Metoclopramide C. Bisacodyl D. Loperamide B Q: A nurse is teaching a client about probiotic supplements. Which of the following info should the nurse include. (Select all that apply) A. Probiotics are microorganisms that are normally found in the GI tract B. Probiotics are used to treat c diff C. Probiotics are used to treat benign postatic hyperplasia D. You can experience bloating while taking probiotic supplements E. If you are prescribed an antibiotic, you should take it at the same time you take your probiotic supplement A, B, D Q: A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1-5 hr after admin? A. Insulin glargine B. NPH insulin C. Regular insulin D. Insulin lispro C Q: A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus. Which of the following tests should the nurse plan to monitor? A. WBC B. Amylase C. Platelet count D. Liver function tests D Q: A nurse is providing teaching to a client who has type 2 diabetes and is starting repaglinide. Which of the following statements by the client indicates understanding of the admin of the med? A. I'll take this med after I eat B. I'll take this med 30 min before I eat C. I'll take this med just before I go to bed D. I'll take this med at least 1 hour before I eat B Q: A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of metformin? A. Somnolence B. Constipation C. Fluid retention D. Weight gain A- somnolence indicates lactic acidosis which is manifested by extreme drowsiness, hyperventilation and muscle pain. Q: A nurse is providing teaching to a client who has a prescription for pramlintide for type 1 diabetes. Which of the following should the nurse include in the teaching? (Select all that apply) A. Take oral meds 30 min before injection B. Use upper arms as preferred injection sites C. Mix pramlintide with the breakfast dose of insulin D. Inject pramlintide just before a meal E. Discard open vials after 28 days D, E Q: A nurse is caring for a client who is taking propylthiouracil. Which of the following findings should the nurse monitor for as an adverse effect of this med? A. Bradycardia B. Insomnia C. Heat intolerance D. Weight loss A Q: A nurse is teaching a client who has Graves' disease and a new prescription for propranolol. Which of the following client statements indicates effective teaching? A. Propranolol helps increase blood flow to my thyroid gland B. Propranolol is used to prevent excess glucose in my blood C. Propranolol will decrease my tremors and fast heart beat D. Propranolol promotes a decrease of thyroid hormone in my body C Q: A nurse is caring for an older adult client who has hypothyroidism and a new prescription for levothyroxine. Which of the following dosage schedules should the nurse expect for this client? A. The client will start at a high dosage and the amount will be tapered as needed B. The client will remain on the initial dosage during the course of treatment C. The clients dosage will be adjusted daily based on blood levels D. The client will start on a low dose which can be gradually increased D- dosage increases gradually over several weeks especially in older adults to prevent toxicity Q: A nurse is caring for a client who is taking for somatotropin to stimulate growth. The nurse should plan to monitor the clients urine for which of the following? A. Bilirubin B. Protein C. Potassium D. Calcium D - expected and puts pt at risk for renal calculi Q: A nurse is reviewing the medical record of a client who takes desmopressin for diabetes insipidus. Which of the following findings is an adverse effect? A. Hypovolemia B. Hypercalcemia C. Agitation D. Headache D Q: A nurse is admitting a client for a total hip anthroplasty. The client takes hydrocortisone for Addison's disease. Which of the following actions is the nurse's priority? A. Administering a supplemental dose of hydrocortisone B. Instructing the client about coughing and deep breathing C. Collecting additional info about the clients history of Addison's disease D. Inserting an indwelling urinary catheter A- acute adrenal insufficiency is greatest risk for pt with Addison's disease taking a glucocorticoid and undergoing surgery Q: Rapid acting insulin (names onset peak & duration LIAG (Lispro, Insulin Aspart, Insulin Glulisine) O: 15-30m P: 30m-2.5 hours D: 3-6 hours Short acting insulin (names onset peak & duration) Regular insulin O: 30m-1 hour P: 1-5 hours D: 6-10 hrs Intermediate insulin (names onset peak & duration) NPH & insulin detemir O: 1-2 hours P: 6-14 hours D: 16-24 hrs Long acting insulin (name onset peak and duration) Insulin glargine O: 70m P: none D: 24 hrs premixed insulin 70 NPH 30 regular 75 lispro protamine 25 lispro 2 OF EACH Thyroid hormone Select prototype med? What is it for? Pregnancy risk class? Levothyroxine For Hypothyroidism, treats underactive thyroid gland/replaces thyroid Treats myxedema (severely advanced hypothyroidism) Pregnancy Risk Category A Thyroid replacement is used during Hypothyroidism? T or F and for what two things? TRUE Maintenance of thyroid hormone levels after surgery or radiation of the thyroid Graves disease Overmedication of thyroid hormone manifestations Thyrotoxicosis (Anxiety, Tachycardia, Chest Pain,Nervousness, Tremors, Palpitations, AbdominalCramping, Heat Intolerance, Fever, Diaphoresis, Weight Loss) Thyroid hormone interactions Increases cardiac responsiveness to catecholamines (epinephrine, dopamine, dobutamine) therebyincreasing the risk of dysrhythmias Thyroid hormone nursing administration considerations? How long will the full effect of the med take? What is the med dosed in? - Monitor and report manifestations of cardiacexcitability - Monitor T4 and TSH levels Full effect of the medication can take 6-8 weeks Medication is dosed in micrograms (mcg) Levothyroxine pt teaching (3) - Take the medication daily on an empty stomach 30 -60 minutes before breakfast - Lifelong replacement is important even after improvement - DO NOT discontinue the medication without checking with the provider Levothyroxine nursing evaluation? - Decreased TSH levels, Evaluation of TSH should not be done until 6 - 8weeks following the start of treatment Thionamides Select prototype meds? (2) Why is it used? (3) - Hyperthryoidism!!!! - Treats Grave's Disease (hyperthyroid) - Used before thyroid sx to produce a euthyroid state (the state of having a normal thyroid gland function) Propylthiouracil (PTU) Methimazole Propylthiouracil (PTU) Hyperthyroidism Used in our pregnant population in the first trimester; thenreplaced with Methimazole after Methimazole Pregnancy class? (first line therapy med) - because it can beused as an emergent treatment of thyrotoxicosis (clinical state of inappropriately high levels of circulating thyroid hormones T3and/or T4) (Pregnancy Risk Category D; in the first trimester) Thionamides (hyperthyroidism treatment) complications Hypothyroidism - Look for signs of hypothyroidism (drowsiness, depression,weight gain, bradycardia, anorexia, cold intolerance Thionamides (hyperthyroidism treatment) Contraindications and Precautions Use of methimazole is contraindicated in pregnancy(Pregnancy Risk Category D; in the first trimester) and during lactation due to the risk of neonatal hypothyroidism Propylthiouracil (PTU) is safer than methimazole duringthe first trimester of pregnancy Thionamides (hyperthyroidism treatment) nursing administration Methimazole and Propylthiouracil do not destroy the thyroid hormone that is present but rather prevent the continued synthesis of TH Thionamides (hyperthyroidism treatment) client education (3) - Therapeutic effects can take 1 - 2 weeks to beevident, while the full benefit can take 3 - 12 weeks - Take the medication at consistent times each day -DO NOT discontinue the medication abruptly (risk ofthyroid crisis due to stress response) Radiopharmaceuticals why use? Select Prototype medication? Pregnancy category? Radioactive Iodine 131 It is possible to destroy the thyroid with onedose of this Because of irradiating effects, use is contraindicatedin pregnancy (Pregnancy Risk Category X) Iodine products Select Prototype medication: Why? Lugol's Solution (SSKI - Saturated Solution of Potassium iodine; or Strong iodine solution: nonradioactive iodine) Nonradioactive iodine creates high levels of iodine that will reduce iodine uptake = shrinking/reducing the thyroidgland! done to reduce the bleeding (or vascularity of the thyroid) Nonradioactive iodine is used for the emergencytreatment of thyrotoxicosis!!!!! Iodine products interactions: Concurrent intake of foods high in iodine (iodized salt,seafood containing iodine) increases the risk for iodism Iodine products client education: Avoid foods high in potassium Disorders of Adrenal Gland 2 most important steroid hormones: ALDOSTERONE: mineralocorticoid CORTISOL: glucocorticoid Addison's disease S/s? - Rare genetic disorder that lacks aldosterone and cortisol - Needs hormone replacement ADDSS Added pigmentation + potassium Hyperkalemia, bronze pigmentation Decreased WEIGHT (water loss) Decreased BP, hair, sugar, energy Sodium (135) WNL is 136-145 Salt craving Cushing's disease Treatment? - Long time use of steroids or genetic disorder - Overabundance of steroids CUSHing (stuck on high) Cushion: Truncial obesity, moon face, buffalo hump Unusual HAIR GROWTH Hairy suit Skin Butterfly mark High High sugar, BP, weight Treatment: take the cause away: 1. Cut out tumor 2. Steroids (slowly decrease) Adrenal hormone replacement for Addison's disease Select prototype medication: Hydrocortisone (glucocorticoid) Other Medications:• Glucocorticoids: - Prednisone - Dexamethasone Adrenal hormone replacement Complications (3) and nursing actions - Glucose Intolerance - Osteoporosis - Adrenal Suppression Nursing Actions: Increase dose with stress. DO NOT stop themedication suddenly. Taper dose to discontinue Diabetes Mellitus problem/patho? NOTE? 2 hormones that bring sugar in or out of cells Insulin: Brings glucose from blood into cells Glucagon: Brings glucose from cells into blood Hypoglycemic reactions to insulin are most likely to occur during the PEAK time Normal Blood Glucose Levels? Normal Blood Glucose Levels: 70 - 105 Rapid-acting: Lispro Insulin Onset: 15 - 30 minutes Peak: 0.5 - 2.5 hours Duration: 3 - 5 hours Short-acting: Regular Insulin Onset: 0.5 - 1 hour Peak: 1 - 5 hours Duration: 6 - 10 hours Intermediate-acting: NPH Insulin (Humulin) Onset: 1 - 2 hours Peak: 6 - 14 hours Duration: 16 - 24 hours Long-acting: Glargine U-100 Onset: 1 - 4 hours Peak: None Duration: 24 hours Premixed Insulin's 70% NPH and 30% regular: Mixture of intermediate and short-acting insulin 75% insulin lispro protamine and 25% insulin lispro: Mixture of intermediate and rapid-acting insulin Diabetes Medication nursing actions? If the client is not fully conscious, do not risk aspiration • Administer Glucose (D5 or D10) parenterally (IV glucose) or SQ/IM Glucagon Oral diabetes meds: antidiabetics Select Prototype Medications (2) Whats important? Glipizide (PO) - tells your pancreas to release insulin -Category C preg Metformin - Reduces the production of glucose within the liver through suppression of gluconeogenesis - !!! biguanide, which lowers the amount of sugar your body makes and absorbs from food DO NOT use alcohol with it -- stresses liver Oral diabetes meds: antidiabetics interactions use of alcohol can result in a Disulfiram-like reaction - A drug that can cause an adverse reaction to alcohol, leading to intense NV, flushing, dizziness, throbbing headache, chest and abdominal discomfort, and palpitations HISTAMINE 2 -RECEPTOR ANTAGONISTS Select-Prototype Medication: Pregnancy category? Be careful about? Cimetidine Other Medications:• Famotidine (Pepcid)• Nizatidine (-DINES) blocks H2 receptors that suppresses gastric acid secretion and lowers H+ ions in stomach, used with antibiotics high risk for pnemonia, COPD pts, kidney impairment Pregnancy Risk Category B HISTAMINE 2 -RECEPTOR ANTAGONISTS Complications (2) 1. locks androgen receptors (sex hormones) - resulting in decreased libido (sex drive), gynecomastia (males get enlarged breasts, and impotence (infertility) 2. Dosages should be reduced in clients with moderate to severekidney impairment HISTAMINE 2 -RECEPTOR ANTAGONISTS nursing interactions Concurrent use of Antacids can decrease absorption of histamine 2 receptor antagonist HISTAMINE 2 -RECEPTOR ANTAGONISTS client education ... for PUD too? Do not take an antacid WITHIN 1 hr before, or after, taking a histamine2 receptor antagonist Avoid alcohol, smoking and foods that increase GI irritation, and limit the use of aspirin and NSAIDs Proton pump inhibitors (PPI) Select-Prototype Medication: Used for? Omeprazole (Prilosec) - stops the stomach from producing both its normal, constant acid (basal acid) and the extra acid triggered by thinking about or eating food. It does this by permanently blocking the enzyme responsible for making stomach acid, leading to reduced acid levels overall -short term therapy Short-term therapy for gastric and duodenal ulcers, erosive esophagitis, and GERD Treatment: 4 to 8 weeks Pregnancy Risk Category C, increased pneumonia risk PPI complications (3) Osteoporosis and Fractures - decreased Ca+ absorption and Mg+• Rebound Acid Hypersecretion - Take a low dose if possible and taper slowly to discontinue Clostridium difficile- associated diarrhea• - Report, fever, diarrhea, abdominal cramping, or bloody stools immediately to the provider MUCOSAL PROTECTANT Select-Prototype Medication: Preg cat? Sucralfate (Carafate) - Interacts with acidic environment of the stomach and duodenum changes sucralfate into a protective barrier that adheres to an ulcer Pregnancy Risk Category B MUCOSAL PROTECTANT Interactions and requirements - Antacids interfere with the effects of sucralfate Antacids Select-Prototype Medication: Aluminum Hydroxide Other Medications: • Magnesium Hydroxide (Milk of Magnesium) • Calcium Carbonate (Tums) Neutralize or reduce the acidity of gastric acid; can reduce pepsin activity Antacids Complications (3) 1. Constipation (Aluminum and Calcium Compounds): Constricts the GI 2. Diarrhea (Magnesium Compounds): Relaxes the GI 3. Fluid Retention• Antacids containing sodium can result in fluid retention (where salt goes, water follows) Antacids Client Education Antacids containing magnesium can cause magnesium to build up in the blood Antacids Interactions - Allow at least 1 hour time between taking antacids and any other medication provider approval PROSTAGLANDIN E ANALOG Select-Prototype Medication? Why is it used? Preg category Misoprostol mimics a natural prostaglandin in the body: Reducing stomach acid production, Increasing bicarbonate (which neutralizes acid), Boosting protective mucus, Improving blood flow in the stomach lining - clients taking long-term NSAIDs or - used in clients who are pregnant only to induce labor by causing cervical ripening Pregnancy Risk Category X GLUCOCORTICOIDS Complications Adrenal insufficiency:, Osteoporosis, Glucose intolerance, Peptic ulcer disease, Sodium retention, Hypokalemia: ANTIEMETICS Glucocorticoids: Dexamethasone: unknown MOA, used for inflammation SUBSTANCE P/NEUROKININ1 ANTAGONISTS Select-Prototype Medication: Emend (aprepitant) - Inhibits substance P (that causes pain in the brain) - PREVENTS emesis by blocking the serotonin receptorsin the chemoreceptor trigger zone (CTZ) SEROTONIN ANTAGONIST Select-Prototype Medication: Ondansetron (Zofran) - Prevents emesis by blocking the serotonin receptors in the chemoreceptor trigger zone (CTZ) SEROTONIN ANTAGONIST Monitor prolonged QT intervals - Can lead to cardiac dysrhythmias - Torsades DePointes Ventricular Fibrillation Death DOPAMINE ANTAGONIST Select-Prototype Medication: - Antiemetic effects result from the blockade of dopamine receptors in the CTZ - Increases gastric emptying 1. Metoclopramide (Reglan): centrally and peripheral acting 2. Promethazine (Phenergan; centrally acting) 3. Prochlorperazine (Phenothiazine) DOPAMINE ANTAGONIST Complications: - Extrapyramidal Symptoms (spasms): Stop the medication immediately and contact the PCP - Hypotension CANNABINOIDS Select-Prototype Medication: Dronabinol - control CINV (Chemotherapy-Induced Nausea and Vomiting) and to increase appetite in clients who have developed AIDS ANTICHOLINERGIC Select-Prototype Medication: Scopolamine - Interferes with the transmission of nerve impulses traveling from the vestibular apparatus of the inner ear to the vomiting center (VC) in the brain (think vertigo) -need to be taken 4 hr before ANTICHOLINERGICS Complications (DUC) Dry Mouth, Urinary Retention, Constipation Blurred Vision -Suck on hard candy or chew gum to help relieve dry mouth LAXATIVES Select-Prototype Medication: and actions... Psyllium (Bulk-Forming) - Bulk-forming laxatives soften fecal mass and increase bulk Docusate Sodium (Surfactant Laxative) - Bisacodyl (Stimulant Laxative) Magnesium Hydroxide (Osmotic Laxative) Senna (Stimulant Laxative) Lactulose (Osmotic Laxative) LAXATIVES-PSYLLIUM (BULKFORMING) Pharmacological Actions - Bulk-forming laxatives soften fecal mass and increase bulk - For temporary treatment of constipation - Control stool for clients who have ileostomy or colostomy LAXATIVES-PSYLLIUM (BULKFORMING) Complications Bulk-forming agents can cause obstruction of the esophagus or intestines LAXATIVES-DOCUSATE SODIUM (SURFACTANT LAXATIVES) Complications - lower the surface tension of thestool to allow the penetration of water --- Sodium absorption and fluid retention• Cardiac patients should not take LAXATIVES-MAGNESIUM HYDROXIDE, LACTULOSE (OSMOTIC LAXATIVES) Pharmacological Actions Lactulose is the ability to draw off ammonia in patients with hepatic encephalopathy LAXATIVES-MAGNESIUM HYDROXIDE, LACTULOSE (OSMOTIC LAXATIVES) Complications Osmotic laxatives can cause dehydration ANTIDIARRHEALS Select Prototype Medication (2): 1. Diphenoxylate Plus Atropine (Lomotil) 2. Loperamide - activate opioid receptors in the GItract to decrease intestinal motility - binding to opiate receptorsites in the myenteric plexus and probably exert their antidiarrheal effects through this mechanism ANTIDIARRHEALS complications At high doses, the client can experience typical opioid effects ANTIDIARRHEALS Contraindications and Precautions increased risk of megacolon Antidiarrheals are a Pregnancy Risk Category C