PHARMACOLOGYEXAM
A+
Qu
est
ion1
2o
uto
f2p
oin
ts
Thenurs
eiscari
ngforapat
ien
twh owil
lb e
gintak
ing
th
eophyl
li
neathome.Duri
ngtheassess
me nt,
thenurs
el e
arns
th
atthepat
ien
tsmokes.Thenurs
er e
portsthi
stotheprovi
der
a
ndwi
ll
expec
ttheprovi
dert
o
Answe
ra.
s
: d
ecr
eas
eth
edo
seo
fth
eop
hyl
li
ne.
b
.
d
isc
ont
inu
eth
eth
eop
hyl
li
ne.
c
.
k
eept
het
heo
phy
ll
in
edos
easo
rde
red
.
d
.
i
ncr
eas
eth
edo
seo
fth
eop
hyl
li
ne.
Resp on s
e AnswerD.Tobac
cos moki
nginc
rease
sthemet
abol
is
mo f
F
eed
ba c
k:
t
heo
p h
yll
ine,s
othedoseshou
ldbeincre
ase
d.Dec
reas
ingt
he
d
osewill
leadtosub
ther
apeut
iceff
ect
s.
· Qu
est
ion2
2o
uto
f2p
oin
ts
Acli
enti
sint
hecli
nict
ohavebl
ooddr
awnt
oasse
ss
t
heophyl
li
nel
eve
ls.Thecl
ie
nta
ppear
stobe
ing
, r
esp
ondingwellt
othemedi
cat
ionan
disnote
xpe
rien
cin
ga n
y
a
dver
seeffe
cts.Whatse
rumle
velwi
llt
henur
seexp
ectthecl
ie
nt
t
ohave?Answer A.
s: Betwe
en10and20mc g/
mL
B.
Be
twe
en25a
nd35
mc
g/mL
C.
Be
twe
en0.
5an
d5mc
g/mL
D.
Be
tween40and50mc g/mL
Re s
p onseAns
we rA.The
rap
eu t
icthe
ophyl
li
nelev
elss
hou
ldb
e
Fe
edba
ck:
bet
ween10and20mc g/mL.Ale
velbet
ween0.
5and5
mc
g/mLwo
uldbelowandwoul
dnotpr
oduc
eathe
rap
eut
icef
fec
t.Le
vel
s
be
tween25and50mcg/mLwou
ldbet
oohi
ghandcoul
dcaus
e
s
erio
usadve
rseeff
ect
s.
· Qu
est
ion3
2o
uto
f2p
oin
ts
Then
urseiscari
ngforapati
entwhoisre
c e
ivi
ngi
ntr
aveno
us
th
eophy
ll
in
e .Thepat
ientc
omp l
ainsofh
ea d
achea
ndn a
usea.
Then
ursewillc
onta
cttheprovi
dertoAnswer a.
s
: c
han
get
heme
dic
ati
ont
oano
ral
the
oph
yll
in
e.
b
.
s
ugge
sta
nal
ter
nat
iveme
thy
lxa
nth
ineme
dic
ati
on.
c
.
o
btai
nano
rde
rfo
ras
eru
mth
eop
hyl
li
ne
l
eve
l.
d
.
r
equ
esta
nor
derf
ora
nan
alge
sicme
dic
ati
on.
Re
spon
se An
swe
rC.Th
eop
hyl
li
neh
asan
arr
owt
her
ape
uti
cin
dexa
nda
F
eed
bac
k
: r
iskf
ors
eve
res
ymp
tomswi
tht
oxi
cle
vel
s.Wh
enp
ati
ent
sre
por
t
, symp t
omso fth e
op h
yll
ineadver
seeffec
ts,aserumdruglev
elshoul
dbe
obta
ined .Gi
vinga noralt
heophy
ll
inewouldonlycompoundtheprob
lemi
f
th
ep ati
e nthasatoxicdrugle
vel.
Analgesicsma ybeu s
ed,butonl
yaftert
oxici
tyisr
ule
do ut
.Ad d
inga
di
fferentme t
hy l
xanth
inewil
lcompoundthesymp t
omsa n
dwi l
lli
kel
y
resu
ltind ru
gi nt
eracti
onorunwantedsyner
gism.
· Qu
est
ion4
2o
uto
f2p
oin
ts
Thecli
entisa34-year-
oldmanwh orec
e nt
lystar
ted
ta
kingtheoph
ylli
ne.Thenurseknowsthatme d
icat
ion
te
achin
gh asbeens u
ccessfu
l wh
e nheagreestowhat
a
cti
vi
ty?Answer A.
s: Takingtheme di
cati
ononane mpt
ys t
o mach
B.
Av
oid
ingb
eve
rage
sth
atc
ont
ainc
aff
ein
e
C.
Ea
tin
gf o
odshi
ghinp
ota
s si
um
D.
Li
miti
ngflu
idi
nta
ket
o1,000mLad
ay
Re
spo
nseAn
swe
rB.Bo
tht
heo
phy
ll
in
ean
dca
ffe
inea
re
F
eed
bac
k
: x
anthenes.The o
phyll
in
ei ncr
easesc a
rdiacout
putan
dh ear
t
r
ate.Caffe
inea l
sosti
mu l
ateshe a
rtrate
.Thiscanha
v ean
a
dditi
vee f
fect.Eat
ingfoodshighinpo t
assi
um,li
mit
ingfl
uid
i
nta
k e,orta
kingtheme dic
ineo nanemp tyst
omachisnotan
i
ndi
c at
ionthatthecl
ienthasun der
stoodthenur
se'
steachi
ng.
·Qu
est
ion5
Thenurs
eistea
chingapat
ien
twh owi
llbe
gint
akin
goral
theo
phyl
li
ne(Theo
Du r
)whendis
char
gedhomefromthehos
pit
al.
Whati
nfo
rmati
onwil
lth
en ur
sein
cludewhente
achi
ngthepat
ien
tabout
t
hisdr
ug?
An
swe
rsa .
: Av
oidca
ffe
inewh
il
eta
kin
gth
isme
dic
ati
on.
, b
.
F
oodwi
ll
dec
rea
set
hea
mou
ntofd
rug
a
bso
rbe
d.c
.
An
ore
xiaa
ndga
str
oin
tes
tin
alu
pse
tar
eun
exp
ect
ed
s
idee
ffe
cts
.d.
Ane
xtr
ado
ses
hou
ldb
eta
kenwh
ens
ymp
tomswo
rse
n.
Resp
on s
e An swerA.Ca ff
eineandt
he ophyl
li
n ear
eb ot
hx a
nthi
nederi
vati
ves
andFeedba
c k
: s h
ouldnotbetake
nt oget
he rbeca
useoftheincr
easedri
skof
to
xici
tyand
sever
ea dver
see f
fect
s.Theophyl
li
n ehasan a
rrowther
apeut
ic
ra
ngea ndmu stbedosedcareful
ly
; pat
ient
sshouldnever
i
ncreaseord ec
reasethedosewithoutconsul
ti
ngthei
rprovi
der.
Gastr
ointest
ina
lsymptomsa r
ec ommons ideeff
ects
.Foodslows
absor
ptionbutdoesnotpreventt
hef ul
ldosefrombein
g
absor
bed .
·Qu
est
ion6
Apat
ien
twh ohasbe
ent
aki
ngtheoph
yll
in
ea thomerepo
rts
ha
vin
gp al
pit
ati
onsa
ndj
it
ter
ine
ss.Whatact
ionwil
lth
en ur
se
t
ake
?
An
swe
rsa.
: Re q
uesta
nor
derf
orr
ena
lfu
nct
ions
tud
ies
.
b.
Not
if
yth
epr
ovi
dert
ore
por
tth
eop
hyl
li
ne
t
oxi
ci
ty.c
.
Askthep
ati
enti
fher
bal
me di
cat
ion
sareuse
d.
d.
Reco
mme ndt
hatt
hepat
ien
tincr
easef
lui
dint
ake
.
Re
spon
seAn
swe
rC.E
phe
drai
sas
timu
lan
tth
atp
ote
nti
ate
sth
eop
hyl
li
nea
ndma
y
A+
Qu
est
ion1
2o
uto
f2p
oin
ts
Thenurs
eiscari
ngforapat
ien
twh owil
lb e
gintak
ing
th
eophyl
li
neathome.Duri
ngtheassess
me nt,
thenurs
el e
arns
th
atthepat
ien
tsmokes.Thenurs
er e
portsthi
stotheprovi
der
a
ndwi
ll
expec
ttheprovi
dert
o
Answe
ra.
s
: d
ecr
eas
eth
edo
seo
fth
eop
hyl
li
ne.
b
.
d
isc
ont
inu
eth
eth
eop
hyl
li
ne.
c
.
k
eept
het
heo
phy
ll
in
edos
easo
rde
red
.
d
.
i
ncr
eas
eth
edo
seo
fth
eop
hyl
li
ne.
Resp on s
e AnswerD.Tobac
cos moki
nginc
rease
sthemet
abol
is
mo f
F
eed
ba c
k:
t
heo
p h
yll
ine,s
othedoseshou
ldbeincre
ase
d.Dec
reas
ingt
he
d
osewill
leadtosub
ther
apeut
iceff
ect
s.
· Qu
est
ion2
2o
uto
f2p
oin
ts
Acli
enti
sint
hecli
nict
ohavebl
ooddr
awnt
oasse
ss
t
heophyl
li
nel
eve
ls.Thecl
ie
nta
ppear
stobe
ing
, r
esp
ondingwellt
othemedi
cat
ionan
disnote
xpe
rien
cin
ga n
y
a
dver
seeffe
cts.Whatse
rumle
velwi
llt
henur
seexp
ectthecl
ie
nt
t
ohave?Answer A.
s: Betwe
en10and20mc g/
mL
B.
Be
twe
en25a
nd35
mc
g/mL
C.
Be
twe
en0.
5an
d5mc
g/mL
D.
Be
tween40and50mc g/mL
Re s
p onseAns
we rA.The
rap
eu t
icthe
ophyl
li
nelev
elss
hou
ldb
e
Fe
edba
ck:
bet
ween10and20mc g/mL.Ale
velbet
ween0.
5and5
mc
g/mLwo
uldbelowandwoul
dnotpr
oduc
eathe
rap
eut
icef
fec
t.Le
vel
s
be
tween25and50mcg/mLwou
ldbet
oohi
ghandcoul
dcaus
e
s
erio
usadve
rseeff
ect
s.
· Qu
est
ion3
2o
uto
f2p
oin
ts
Then
urseiscari
ngforapati
entwhoisre
c e
ivi
ngi
ntr
aveno
us
th
eophy
ll
in
e .Thepat
ientc
omp l
ainsofh
ea d
achea
ndn a
usea.
Then
ursewillc
onta
cttheprovi
dertoAnswer a.
s
: c
han
get
heme
dic
ati
ont
oano
ral
the
oph
yll
in
e.
b
.
s
ugge
sta
nal
ter
nat
iveme
thy
lxa
nth
ineme
dic
ati
on.
c
.
o
btai
nano
rde
rfo
ras
eru
mth
eop
hyl
li
ne
l
eve
l.
d
.
r
equ
esta
nor
derf
ora
nan
alge
sicme
dic
ati
on.
Re
spon
se An
swe
rC.Th
eop
hyl
li
neh
asan
arr
owt
her
ape
uti
cin
dexa
nda
F
eed
bac
k
: r
iskf
ors
eve
res
ymp
tomswi
tht
oxi
cle
vel
s.Wh
enp
ati
ent
sre
por
t
, symp t
omso fth e
op h
yll
ineadver
seeffec
ts,aserumdruglev
elshoul
dbe
obta
ined .Gi
vinga noralt
heophy
ll
inewouldonlycompoundtheprob
lemi
f
th
ep ati
e nthasatoxicdrugle
vel.
Analgesicsma ybeu s
ed,butonl
yaftert
oxici
tyisr
ule
do ut
.Ad d
inga
di
fferentme t
hy l
xanth
inewil
lcompoundthesymp t
omsa n
dwi l
lli
kel
y
resu
ltind ru
gi nt
eracti
onorunwantedsyner
gism.
· Qu
est
ion4
2o
uto
f2p
oin
ts
Thecli
entisa34-year-
oldmanwh orec
e nt
lystar
ted
ta
kingtheoph
ylli
ne.Thenurseknowsthatme d
icat
ion
te
achin
gh asbeens u
ccessfu
l wh
e nheagreestowhat
a
cti
vi
ty?Answer A.
s: Takingtheme di
cati
ononane mpt
ys t
o mach
B.
Av
oid
ingb
eve
rage
sth
atc
ont
ainc
aff
ein
e
C.
Ea
tin
gf o
odshi
ghinp
ota
s si
um
D.
Li
miti
ngflu
idi
nta
ket
o1,000mLad
ay
Re
spo
nseAn
swe
rB.Bo
tht
heo
phy
ll
in
ean
dca
ffe
inea
re
F
eed
bac
k
: x
anthenes.The o
phyll
in
ei ncr
easesc a
rdiacout
putan
dh ear
t
r
ate.Caffe
inea l
sosti
mu l
ateshe a
rtrate
.Thiscanha
v ean
a
dditi
vee f
fect.Eat
ingfoodshighinpo t
assi
um,li
mit
ingfl
uid
i
nta
k e,orta
kingtheme dic
ineo nanemp tyst
omachisnotan
i
ndi
c at
ionthatthecl
ienthasun der
stoodthenur
se'
steachi
ng.
·Qu
est
ion5
Thenurs
eistea
chingapat
ien
twh owi
llbe
gint
akin
goral
theo
phyl
li
ne(Theo
Du r
)whendis
char
gedhomefromthehos
pit
al.
Whati
nfo
rmati
onwil
lth
en ur
sein
cludewhente
achi
ngthepat
ien
tabout
t
hisdr
ug?
An
swe
rsa .
: Av
oidca
ffe
inewh
il
eta
kin
gth
isme
dic
ati
on.
, b
.
F
oodwi
ll
dec
rea
set
hea
mou
ntofd
rug
a
bso
rbe
d.c
.
An
ore
xiaa
ndga
str
oin
tes
tin
alu
pse
tar
eun
exp
ect
ed
s
idee
ffe
cts
.d.
Ane
xtr
ado
ses
hou
ldb
eta
kenwh
ens
ymp
tomswo
rse
n.
Resp
on s
e An swerA.Ca ff
eineandt
he ophyl
li
n ear
eb ot
hx a
nthi
nederi
vati
ves
andFeedba
c k
: s h
ouldnotbetake
nt oget
he rbeca
useoftheincr
easedri
skof
to
xici
tyand
sever
ea dver
see f
fect
s.Theophyl
li
n ehasan a
rrowther
apeut
ic
ra
ngea ndmu stbedosedcareful
ly
; pat
ient
sshouldnever
i
ncreaseord ec
reasethedosewithoutconsul
ti
ngthei
rprovi
der.
Gastr
ointest
ina
lsymptomsa r
ec ommons ideeff
ects
.Foodslows
absor
ptionbutdoesnotpreventt
hef ul
ldosefrombein
g
absor
bed .
·Qu
est
ion6
Apat
ien
twh ohasbe
ent
aki
ngtheoph
yll
in
ea thomerepo
rts
ha
vin
gp al
pit
ati
onsa
ndj
it
ter
ine
ss.Whatact
ionwil
lth
en ur
se
t
ake
?
An
swe
rsa.
: Re q
uesta
nor
derf
orr
ena
lfu
nct
ions
tud
ies
.
b.
Not
if
yth
epr
ovi
dert
ore
por
tth
eop
hyl
li
ne
t
oxi
ci
ty.c
.
Askthep
ati
enti
fher
bal
me di
cat
ion
sareuse
d.
d.
Reco
mme ndt
hatt
hepat
ien
tincr
easef
lui
dint
ake
.
Re
spon
seAn
swe
rC.E
phe
drai
sas
timu
lan
tth
atp
ote
nti
ate
sth
eop
hyl
li
nea
ndma
y
