NUR 335 RN Pharmacology Online Practice Test with Answers

RN Pharmacology VATI Re-evaluation Assessment The nurse should teach the client to discard any regular insulin that appears cloudy, as regular insulin should be clear. NPH insulin has a cloudy appearance. The nurse should teach the client to inject air into the NPH vial first. The nurse should teach the client to draw up the regular insulin into the syringe first. Nystatin oral suspension should be stored at room temperature. The action of nystatin is local, and it is not absorbed through intact skin or mucous membranes. There is no reason to take the medication on an empty stoma. Nystatin must be swallowed to maximize the medication's local effects on the mucosal lining of the upper gastrointestinal tract. Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron supplements between meals helps to increase the bioavailability of the iron. Taking the medication with food can reduce the GI symptoms associated with it. However, taking the medication between meals maximizes absorption Reclining immediately after taking ferrous sulfate may lead to esophageal corrosion. Clients should remain upright for 15-30 min following administering. The nurse should explain that feverfew interferes with platelet action and can therefore cause bleeding. It is unsafe for the client to take during pregnancy. Sucralfate for gastric ulcer: The nurse should administer the medication to the client on an empty stomach for best absorption. The nurse should instruct the client to increase fluids while on sucralfate therapy to decrease the risk of constipation related to the medication. The nurse should instruct the client to avoid taking antacids 30 min before or after the administration of sucralfate. Packed red blood cells for anemic patient: The nurse should check the client's vital signs every 15 min at the start of the transfusion, then every 1 hr to monitor for a transfusion reaction. (answer said “check the clients vitals every hour) (I chose to infuse at rate of 200 ml/hr) The transfusion should infuse in 2 to 4 hr to prevent fluid overload. Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma. The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing the pill destroys that protection. Crushing the pill will destroy the enteric coating, and the client should be advised against this, but the enteric coating does not prevent the release of medication. Sustained release preparations disburse the medication over time. Phenytoin is an anticonvulsant used to treat various types of seizures. Clients on anticonvulsant medications commonly require them for lifetime administration, and phenytoin should not be stopped without the advice of the client's provider. The client understands that phenytoin causes an overgrowth of the gums that makes dental monitoring important. Furosemide is correct. This medication is used to reduce edema and hypertension, and an adverse effect is orthostatic hypotension. Telmisartan is correct. This medication is used to control hypertension, and an adverse effect is orthostatic hypotension. Duloxetine is correct. This medication is used to treat depression and anxiety disorder, and an adverse effect is orthostatic hypotension. Clopidogrel is incorrect. This medication is used to reduce the risk of MI and stroke and does not cause orthostatic hypotension. Atorvastatin is incorrect. This medication is used to decrease cholesterol and does not cause orthostatic hypotension. Captopril: neutropenia Captopril, an ACE inhibitor, can cause hyperkalemia due to potassium retention by the kidney. The client should avoid salt substitutes, as most of them are high in potassium. The client should take captopril on an empty stomach, 1 hr before or 2 hr after a meal, in order to not reduce the medication’s absorption. The nurse should teach the client that extended release tablets should be taken whole and should not be broken, crushed, or chewed. The client should avoid activities that require alertness. Diazepam is a benzodiazepine that causes sedation and dizziness. The client should take this medication intermittently (3 or 4 nights per week) to prevent physical dependence. Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid. Hyperventilation can cause respiratory alkalosis. Hypermetabolism, such as with fever or exercise, can cause metabolic acidosis. Respiratory depression can cause respiratory acidosis. The client should keep the vial in use at room temperature to minimize tissue injury and to reduce the risk for lipodystrophy. (insulin) The client should inject the medication into subcutaneous tissue. The client should mix compatible solutions, such as regular insulin and NPH insulin, to reduce the need for an additional injection and reduce the risk for lipodystrophy. Adverse effects of nalbuphine include visual disturbances such as miosis, blurred vision, and diplopia. Nalbuphine can cause constipation, cramps, and abdominal pain, but it does not have diarrhea as an adverse effect. Nalbuphine is unlikely to cause joint pain; however, it can cause headache and abdominal cramps. Nalbuphine is unlikely to cause oliguria; however, it can cause urinary urgency. Lithium is a salt. If sodium level falls, the client will retain lithium and have an increased risk for lithium toxicity. The nurse should first assess the client’s airway and oxygen saturation to determine the need for respiratory support. Intubation or tracheotomy is considered if adequate oxygenation is not maintained. The second step the nurse should take is to call the rapid response team to provide emergency treatment in case of cardiac or respiratory arrest. Next, the nurse should apply high-flow oxygen to increase oxygenation and then initiate an IV site, if one is not present, and administer isotonic IV fluids to prevent hypotension and provide access for IV medications. The nurse should then administer IV epinephrine to constrict blood vessels, dilate bronchioles, and increase cardiac function. And finally, the nurse should administer IV antihistamines and corticosteroids to block the effects of histamine and decrease edema. Furosemide is a loop diuretic that promotes the excretion of potassium. The nurse should monitor the client's potassium level to watch for hypokalemia. Grapefruits and grapefruit juice can reduce metabolism of atorvastatin, which increases the risk for toxicity. Clay-colored stools are a manifestation of hepatotoxicity, an adverse effect to atorvastatin. Clients who are taking atorvastatin should have their liver enzymes assessed before treatment and 1 to 2 months initially, then in 6 to 12 weeks, and periodically during therapy. They should also have their cholesterol levels monitored to evaluate the effects of treatment. Expect to feel the medication's effects immediately is incorrect. It may take 3 to 6 weeks to achieve the medication's therapeutic effects. Do not drink alcoholic beverages while taking this medication is correct. Alcohol ingestion can increase the risk of liver damage. Report unexplained bruising to the provider is correct. Methotrexate can cause thrombocytopenia. Clients should report bruising or petechiae as they may indicate a low platelet count. Avoid people who have infections is correct. Methotrexate causes bone marrow suppression and increases the risk for infection Take NSAIDs to help minimize the adverse effects of the medication is incorrect. NSAIDs interact with methotrexate and should be avoided. Providers sometimes prescribe folic acid to help minimize the side effects of methotrexate. Hypokalemia is an adverse effect of cisplatin. So is diarrhea, tinnitus and weight gain Z track method: Aspirating for 5 to 10 seconds allows blood in a small blood vessel to appear, an indication that the nurse should withdraw the needle and prepare a fresh injection. The nurse should insert the needle at a 90° angle. The nurse should pull the skin 2.5 cm (1 in) to 3.5 cm (1.4 in) down or to the side to make it easier to insert the needle. The major manifestations of diabetes insipidus are excessive urination and extreme thirst. Vasopressin is used to control frequent urination, increased thirst, and loss of water associated with diabetes insipidus. A decreased urine output is the desired response. An increase in specific gravity (indicating a more concentrated urine) would be the desired response of vasopressin. Diabetes insipidus causes the loss of large amounts of urine, which can lead to hypotension. An increase (or at least no further decrease) in blood pressure would be the desired response to vasopressin. Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency. Fluid retention is an adverse effect of prednisone. Hyperglycemia is an adverse effect of prednisone, Fluid retention is an adverse effect of prednisone. Rebound pulmonary congestion should not occur with withdrawal of prednisone. Prednisone has no direct effect on the client's pulmonary congestion. Glipizide is an oral antidiabetic medication in the pharmacological classification of sulfonylurea agents. These medications help to lower blood glucose levels in clients who have type 2 diabetes mellitus using several methods, including reducing glucose output by the liver, increasing peripheral sensitivity to insulin, and stimulating the release of insulin from the functioning beta cells of the pancreas. Glipizide is an oral antidiabetic medication in the pharmacological classification of sulfonylurea agents. Sulfonylurea agents reduce the glucose output of the liver. The medication should be administered (in a thin line) into the conjunctival sac, rather than being placed directly on the globe of the eye. This ensures that more of the medication comes in contact with the surfaces of the eye when the child blinks. If applied to the globe of the eye, most of the medication will end up in the child's lashes when the child closes her eye. The caregiver should position the child with the head extended, and ask the child to look up before applying the ointment. Use of a sterile glove and applicator is not necessary. Ophthalmic ointments are applied directly from the tube, using clean technique. The first bead of ointment should be discarded, as it is considered to be contaminated. The tube should not be allowed to touch the eye, and it should be recapped as soon as the ointment has been dispensed. The caregiver should be taught to wipe from the inner canthus (closer to the nose) to the outer canthus (closer to the ear) to avoid cross-contamination of the unaffected eye and lacrimal duct with secretions. Calcium carbonate is a dietary supplement used when the amount of calcium taken in the diet is not enough. Calcium carbonate may also be used as an antacid to relieve heartburn, acid indigestion, and stomach upset. The client should drink a full glass of water after taking an antacid to enhance its effectiveness. The major adverse effect of calcium carbonate is constipation. The nurse should recommend the client increase bulk in the diet. Clients who take aluminum hydroxide, not calcium carbonate, antacids should be advised against excessive sodium intake in the diet. Taking calcium carbonate with milk predisposes the client to milk alkali syndrome, which is characterized by headache, confusion, nausea, vomiting, alkalosis, and hypercalcemia. Mydriatic eye drops can cause systemic anticholinergic effects, such as constipation and dry mouth. Mydriatic eye drops are more likely to cause fever than hypothermia. Mydriatic eye drops are more likely to cause tachycardia, not bradycardia.