PHARM FINAL 100 QUESTIONS AND CORRECT VERIFIED ANSWERS

PHARM FINAL 100 QUESTIONS AND
CORRECT VERIFIED ANSWERS
1.A2AA2nurseA2isA2monitoringA2aA2clientA2whoA2isA2receivingA2EpoetinA2alfaA2forA2adverseA2
effects.A2TheA2nurseA2shouldA2identifyA2whichA2ofA2theA2followingA2findingsA2asA2anA2adver
seA2effectA2ofA2thisA2medication?
a.A2EdemaA2andA2hematuria
b.A2BlurredA2visionA2andA2edema
c.A2UrinaryA2retentionA2andA2abdominalA2pain
d.A2HypertensionA2andA2headacheA2-A2Ans--D.
HypertensionA2andA2headache.

2.A2AA2patientA2withA2Parkinson'sA2diseaseA2isA2takingA2levodopa/
carbidopaA2[Sinemet]A2andA2reportsA2occasionalA2periodsA2ofA2lossA2ofA2drugA2effectA2lasti
ngA2fromA2minutesA2toA2severalA2hours.A2TheA2nurseA2questionsA2theA2patientA2furtherA2an
dA2discoversA2thatA2theseA2episodesA2occurA2atA2differentA2timesA2relatedA2toA2theA2medic
ationA2administration.A2TheA2nurseA2willA2contactA2theA2providerA2toA2discuss:
a.A2administeringA2aA2catechol-O-
methyltransferaseA2(COMT)A2inhibitor,A2suchA2asA2entacapone.
b.A2addingA2theA2DA-releasingA2agentA2amantadineA2toA2theA2regimen.
c.A2givingA2aA2direct-actingA2dopamineA2agonist.
d.A2shorteningA2theA2dosingA2intervalA2ofA2levodopa/carbidopa.A2-A2Ans--A
ThisA2patientA2isA2describingA2abruptA2lossA2ofA2effect,A2orA2theA2"off"A2phenomenon,A2whi
chA2isA2treatedA2with
entacaponeA2orA2anotherA2COMTA2inhibitor.A2AmantadineA2isA2usedA2toA2treatA2dyskinesi
as.A2AA2direct-
actingA2dopamineA2agonistA2isA2usefulA2forA2gradualA2lossA2ofA2effect,A2whichA2occursA2atA
2theA2endA2ofA2the
dosingA2intervalA2asA2theA2doseA2isA2wearingA2off.A2ShorteningA2theA2dosingA2intervalA2do
esA2notA2helpA2with
abruptA2lossA2ofA2effect.

3.A2AA2patientA2withA2atrialA2fibrillationA2isA2receivingA2warfarinA2[Coumadin].A2TheA2nurseA
2notesA2thatA2theA2patient'sA2INRA2isA22.7.A2BeforeA2givingA2theA2nextA2doseA2ofA2warfarin,A
2theA2nurseA2willA2notifyA2theA2providerA2and:
a.A2administerA2theA2doseA2asA2ordered.
b.A2requestA2anA2orderA2toA2decreaseA2theA2dose.
c.A2requestA2anA2orderA2toA2giveA2vitaminA2KA2(phytonadione).
d.A2requestA2anA2orderA2toA2increaseA2theA2dose.A2-A2Ans--A
ThisA2patientA2hasA2anA2INRA2inA2theA2appropriateA2range,A2whichA2isA22A2toA23A2forA2most
A2patientsA2andA22.5A2to
3.5A2forA2some,A2soA2noA2changeA2inA2warfarinA2dosingA2isA2necessary.A2ItA2isA2notA2correc
tA2toA2requestA2anA2order

,toA2eitherA2decreaseA2orA2increaseA2theA2doseA2ofA2warfarin.A2ItA2isA2notA2necessaryA2toA2g
iveA2vitaminA2K,A2whichA2isA2anA2antidoteA2forA2warfarinA2toxicity.

4.A2AA265-year-
oldA2patientA2whoA2receivesA2glucocorticoidsA2forA2arthritisA2isA2admittedA2toA2theA2hospita
lA2forA2treatmentA2ofA2aA2urinaryA2tractA2infection.A2TheA2prescriberA2hasA2orderedA2intrave
nousA2ciprofloxacinA2[Cipro].A2BeforeA2administeringA2theA2thirdA2doseA2ofA2thisA2drug,A2th
eA2nurseA2reviewsA2theA2bacterialA2cultureA2reportA2andA2notesA2thatA2theA2causativeA2org
anismA2isA2EscherichiaA2coli.A2TheA2bacterialA2sensitivityA2reportA2isA2pending.A2TheA2pati
entA2complainsA2ofA2rightA2ankleA2pain.A2WhatA2willA2theA2nurseA2do?
a.A2WithholdA2theA2doseA2ofA2ciprofloxacinA2andA2notifyA2theA2providerA2ofA2theA2patient's
symptoms.
b.A2InstructA2theA2patientA2toA2exerciseA2theA2rightA2footA2andA2ankleA2toA2minimizeA2theA2p
ain.
c.A2QuestionA2theA2patientA2aboutA2theA2consumptionA2ofA2milkA2andA2anyA2otherA2dairyA2p
roducts.
d.A2RequestA2anA2orderA2toA2increaseA2thisA2patient'sA2doseA2ofA2glucocorticoids.A2-
A2Ans--A
AA2rareA2butA2seriousA2adverseA2effectA2associatedA2withA2fluoroquinolonesA2isA2tendonA2r
upture,A2andA2those
atA2highestA2riskA2areA2children,A2patientsA2olderA2thanA260A2years,A2transplantA2patients,A
2andA2anyA2patients
takingA2glucocorticoids.A2AnyA2painA2inA2eitherA2heelA2shouldA2beA2reportedA2andA2theA2dr
ugA2shouldA2be
discontinued.A2PatientsA2shouldA2beA2instructedA2notA2toA2exerciseA2untilA2tendonitisA2has
A2beenA2ruledA2out.
DairyA2productsA2canA2reduceA2theA2absorptionA2ofA2ciprofloxacin,A2soA2thisA2isA2notA2aA2c
oncernA2withA2this
patient.A2BecauseA2theA2painA2mayA2beA2causedA2byA2tendonitisA2associatedA2withA2ciprof
loxacin,A2itA2isA2not
correctA2toA2requestA2anA2increaseA2inA2theA2glucocorticoidA2dosing.

5.A2AA2patientA2whoA2isA2anA2opioidA2addictA2hasA2undergoneA2detoxificationA2withA2bupre
norphineA2[Subutex]
andA2hasA2beenA2givenA2aA2prescriptionA2forA2buprenorphineA2withA2naloxoneA2[Suboxone
].A2TheA2patient
asksA2theA2nurseA2whyA2theA2drugA2wasA2changed.A2WhichA2responseA2byA2theA2nurseA2is
A2correct?
a.A2"SuboxoneA2hasA2aA2lowerA2riskA2ofA2abuse."
b.A2"SuboxoneA2hasA2aA2longerA2half-life."
c.A2"SubutexA2causesA2moreA2respiratoryA2depression."
d.A2"SubutexA2hasA2moreA2buprenorphine."A2-A2Ans--A
TheA2combinationA2ofA2buprenorphineA2andA2naloxoneA2[Suboxone]A2discouragesA2intrav
enousA2abuse,
becauseA2withA2IVA2use,A2theA2naloxoneA2precipitatesA2withdrawal;A2thisA2effectA2doesA2n
otA2occurA2with

,sublingualA2dosingA2[Subutex].A2SuboxoneA2doesA2notA2differA2fromA2SubutexA2inA2termsA
2ofA2drugA2halflife.
SubutexA2doesA2notA2causeA2moreA2respiratoryA2depressionA2andA2doesA2notA2containA2m
ore
buprenorphine.

6.A2AA2clinicA2patientA2whoA2hasA2beenA2takingA2aA2glucocorticoidA2forA2arthritisA2forA2seve
ralA2monthsA2remarks
toA2theA2nurse,A2"It'sA2aA2goodA2thingA2myA2symptomsA2areA2better,A2becauseA2myA2mothe
rA2hasA2beenA2quiteA2ill,
andA2IA2haveA2toA2takeA2careA2ofA2her."A2TheA2patient'sA2bloodA2pressureA2isA2100/60A2mm
A2Hg.A2TheA2nurseA2will
reportA2thisA2toA2theA2providerA2andA2askA2about:
a.A2reducingA2theA2patient'sA2dose.
b.A2usingA2everyA2otherA2dayA2dosing.
c.A2increasingA2theA2patient'sA2dose.
d.A2taperingA2theA2dose.A2-A2Ans--C
BecauseA2ofA2theirA2adrenalA2suppression,A2patientsA2takingA2glucocorticoidsA2longA2term
A2require
increasedA2dosesA2atA2timesA2ofA2stressA2andA2evenA2forA2aA2timeA2afterA2stoppingA2theA2d
rugA2untilA2adrenal
functionA2returns.A2ThisA2patient'sA2lowerA2bloodA2pressureA2isA2anA2indicationA2thatA2gluc
ocorticoidA2levels
mayA2beA2depleted.A2ReducingA2theA2doseA2wouldA2onlyA2exacerbateA2theA2patient'sA2pro
blems.A2Every
otherA2dayA2dosingA2isA2usedA2earlyA2inA2glucocorticoidA2therapyA2toA2reduceA2adrenalA2su
ppression,A2butA2it
wouldA2notA2beA2usefulA2now.A2TaperingA2ofA2dosesA2isA2usedA2toA2allowA2adrenalA2functio
nA2toA2recoverA2asA2the
drugA2isA2discontinued.

7.A2AA230-year-oldA2maleA2patientA2willA2beginA2aA2three-
drugA2regimenA2toA2treatA2pepticA2ulcerA2disease.A2The
regimenA2willA2consistA2ofA2bismuthA2subsalicylate,A2tetracycline,A2andA2cimetidineA2[Taga
met].A2The
nurseA2willA2includeA2whichA2informationA2whenA2teachingA2thisA2patientA2aboutA2thisA2dru
gA2regimen?
a.A2BlackA2discolorationA2ofA2theA2tongueA2andA2stoolsA2shouldA2beA2reportedA2immediatel
y.
b.A2CentralA2nervousA2systemA2depressionA2andA2confusionA2areA2likelyA2toA2occur.
c.A2DecreasedA2libido,A2impotence,A2andA2gynecomastiaA2areA2reversibleA2sideA2effects.
d.A2StainingA2ofA2theA2teethA2mayA2occurA2andA2isA2anA2indicationA2forA2discontinuationA2of
A2these
drugs.A2-A2Ans--C
CimetidineA2hasA2antiandrogenicA2effectsA2andA2canA2causeA2decreasedA2libido,A2impote
nce,A2and

, gynecomastia.A2TheseA2effectsA2areA2reversible.A2BlackA2stoolsA2andA2discolorationA2ofA2t
heA2tongueA2are
sideA2effectsA2associatedA2withA2bismuthA2butA2areA2notA2harmful.A2CentralA2nervousA2sys
temA2(CNS)
depressionA2andA2confusionA2areA2notA2likely.A2StainingA2ofA2theA2teethA2associatedA2with
A2tetracyclineA2use
occursA2onlyA2inA2developingA2teeth;A2itA2isA2aA2problemA2inA2childrenA2youngerA2thanA28A2
yearsA2andA2in
pregnantA2womanA2becauseA2ofA2thisA2riskA2toA2theA2fetus.

8.A2AA2nurseA2providesA2teachingA2toA2aA2patientA2whoA2willA2beginA2takingA2oralA2cycloph
osphamideA2toA2treat
non-
Hodgkin'sA2lymphoma.A2WhichA2statementA2byA2theA2patientA2indicatesA2anA2understandi
ngA2about
howA2toA2minimizeA2sideA2effectsA2whileA2takingA2thisA2drug?
a.A2"IA2don'tA2needA2toA2worryA2aboutA2boneA2marrowA2suppressionA2withA2thisA2drug."
b.A2"IA2shouldA2drinkA2plentyA2ofA2fluidsA2whileA2takingA2thisA2drug."
c.A2"IA2shouldA2takeA2thisA2drugA2onA2anA2emptyA2stomach."
d.A2"IfA2IA2shampooA2lessA2often,A2IA2canA2preventA2hairA2loss."A2-A2Ans--B
AcuteA2hemorrhagicA2cystitisA2canA2occur;A2thisA2canA2beA2minimizedA2byA2maintainingA2a
dequate
hydrationA2andA2takingA2mesnaA2[Mesnex],A2aA2protectiveA2agent.A2BoneA2marrowA2suppr
essionA2isA2aA2doselimiting
sideA2effect.A2ThisA2drugA2shouldA2beA2takenA2withA2food.A2HairA2lossA2cannotA2beA2preve
ntedA2by
shampooingA2lessA2often.

9.A2InsulinA2glargineA2isA2prescribedA2forA2aA2hospitalizedA2patientA2whoA2hasA2diabetes.A2
WhenA2willA2theA2nurse
expectA2toA2administerA2thisA2drug?
a.A2ApproximatelyA215A2toA230A2minutesA2beforeA2eachA2meal
b.A2InA2theA2morningA2andA2atA24:00A2PM
c.A2OnceA2dailyA2atA2bedtime
d.A2AfterA2mealsA2andA2atA2bedtimeA2-A2Ans--C
GlargineA2insulinA2isA2indicatedA2forA2onceA2dailyA2subcutaneousA2administrationA2toA2trea
tA2adultsA2and
childrenA2withA2typeA21A2diabetesA2andA2adultsA2withA2typeA22A2diabetes.A2AccordingA2toA2t
heA2package
labeling,A2theA2once-
dailyA2injectionA2shouldA2beA2givenA2atA2bedtime.A2GlargineA2insulinA2shouldA2notA2be
givenA2moreA2thanA2onceA2aA2day,A2althoughA2someA2patientsA2requireA2bidA2dosingA2toA2
achieveA2aA2fullA224
hoursA2ofA2basalA2coverage.