NURS 170 Pharmacology Test 2 QUESTIONS & ANSWERS Galen College (New 2022/2023) Pharmacology test 2

NURS 170 Pharmacology Test 2 QUESTIONS & ANSWERS Galen College (New 2022/2023) Pharmacology test 2 Question 1 1 / 1 pts A nursing student asks the nurse to explain the role of cyclooxygenase-2 (COX-2) and its role in inflammation. The nurse will explain that COX-2 Converts arachidonic acid into prostaglandins. Directly causes vasodilation and increased capillary permeability. Irritates the gastric mucosa to cause gastrointestinal upset. Inactivates bradykinins to cause inflammation and pain. Question 2 1 / 1 pts A nursing student asks how nonsteroidal antiinflammatory drugs (NSAIDs) work to suppress inflammation and reduce pain. The nurse will explain that NSAIDs Exert direct actions to cause relaxation of smooth muscle. Inhibit cyclooxygenase that is necessary for prostaglandin synthesis. Interfere with neuronal pathways associated with prostaglandin action. Suppress prostaglandin activity by blocking tissue receptor sites. Question 3 1 / 1 pts A patient who is taking aspirin for arthritis pain asks the nurse why it also causes gastrointestinal upset. The nurse understands that this is because aspirin Decreases gastrointestinal secretions. Increases hypersensitivity reactions. Inhibits both COX-1 and COX-2. Is an acid-base compound Question 4 1 / 1 pts A patient is taking aspirin to help prevent myocardial infarction and is experiencing moderate gastrointestinal upset. The nurse will contact the patient’s provider to discuss changing from aspirin to which drug? A COX-2 inhibitor Celecoxib (Celebrex) Enteric-coated aspirin (Ecotrin) Nabumetone (Relafen) Question 5 1 / 1 pts The nurse is performing a health history on a patient who has arthritis. The patient reports tinnitus. Suspecting a drug adverse effect, the nurse will ask the patient about which medication? Aspirin (Bayer) Acetaminophen (Tylenol) Anakinra (Kineret) Prednisone (Deltasone) Question 6 1 / 1 pts A patient who takes high-dose aspirin to treat rheumatoid arthritis has a serum salicylate level of 35 mg/dL. The nurse will perform which action? Assess the patient for tinnitus. Monitor the patient for signs of Reye’s syndrome. Notify the provider of severe aspirin toxicity. Request an order for an increased aspirin dose. Question 7 1 / 1 pts The nurse is caring for a postoperative woman who is refusing opioid analgesics but is rating her pain as a 7 or 8 on a 10-point pain scale. The nurse will contact the provider to request an order for which analgesic medication? Diclofenac sodium (Voltaren) Ketoprofen (Orudis) Ketorolac (Toradol) Naproxyn (Naprosyn) Question 8 1 / 1 pts A patient who has osteoarthritis with mild to moderate pain asks the nurse about taking over-thecounter ibuprofen (Motrin). What will the nurse tell this patient? “It may take several weeks to achieve therapeutic effects.” “Unlike aspirin, there is no increased risk of bleeding with ibuprofen.” “Take ibuprofen once daily for maximum analgesic benefit.” “Combine ibuprofen with acetaminophen for best effect.” Question 9 1 / 1 pts The nurse is caring for a patient who has rheumatoid arthritis and who is receiving infliximab (Remicade) IV every 8 weeks. Which laboratory test will the nurse anticipate that this patient will need? Calcium level Complete blood count Electrolytes Potassium Question 10 1 / 1 pts The nurse is teaching a patient about taking colchicine to treat gout. What information will the nurse include when teaching this patient about this drug? Avoid all alcohol except beer. Include salmon in the diet. Increase fluid intake. Take on an empty stomach. Question 11 Allopurinol (Zyloprim) Colchicine Probenecid (Benemid) Sulfinpyrazone (Anturane) Question 12 1 / 1 pts The nurse is assessing a patient who has gout who will begin taking allopurinol (Zyloprim). The nurse reviews the patient’s medical record and will be concerned about which laboratory result? Elevated BUN and creatinine Decreased serum uric acid Slight increase in the white blood count Increased serum glucose Question 13 1 / 1 pts The parent of a 5-year-old child asks the nurse to recommend an over-the-counter pain medication for the child. Which analgesic will the nurse recommend? Aspirin (Ecotrin) Diflunisal (Dolobid) Tylenol #2 (Acetaminophen + Codeine) Acetaminophen (Tylenol) Question 14 1 / 1 pts The nurse is performing an admission assessment on an adolescent who reports taking extrastrength acetaminophen (Tylenol) regularly to treat daily headaches. The nurse will notify the patient’s provider and discuss an order for A selective serotonin receptor agonist (SSRA). Hydrocodone with acetaminophen for headache pain. Liver enzyme tests. An adolescent female has dysmenorrhea associated with heavy menstrual periods. The patient’s provider has recommended ibuprofen (Motrin). When teaching this patient about this drug, the nurse will tell her that ibuprofen May decrease the effectiveness of oral contraceptive pills. May increase bleeding during her period. Should be taken on an empty stomach to increase absorption. Will decrease the duration of her periods. Question 16 1 / 1 pts The nurse is performing an admission assessment on a stable patient admitted after a motor vehicle accident. The patient reports having “bad pain.” What will the nurse do first? Administer acetaminophen (Tylenol). Ask the patient to rate the pain on a 1 to 10 scale. Attempt to determine what type of pain the patient has. Request an order for an intravenous opioid analgesic. Question 17 1 / 1 pts The nurse assumes care of a patient in the post-anesthesia care unit (PACU). The patient had abdominal surgery and is receiving intravenous morphine sulfate for pain. The patient is asleep and has just voided. The nurse assesses a respiratory rate of 10 breaths per minute and notes normal bowel sounds. The nurse will contact the surgeon to report which condition? Paralytic ileus Respiratory depression Somnolence Urinary retention Question 18 1 / 1 pts One hour after receiving intravenous morphine sulfate, a patient reports generalized itching. The nurse assesses the patient and notes clear breath sounds, no rash, respirations of 14 breaths per minute, a heart rate of 68 beats per minute, and a blood pressure of 110/70 mm Hg. Which action will the nurse take? Administer naloxone to reverse opiate overdose. Have resuscitation equipment available at the bedside. Prepare an epinephrine injection in case of an anaphylactic reaction. Reassure the patient that this is a common side effect of this drug. Question 19 1 / 1 pts The nurse is caring for a patient who was admitted with a fractured leg and for observation of a closed head injury after a motor vehicle accident. The patient reports having pain at a level of 3 on a 1 to 10 pain scale. The nurse will expect the provider to order which analgesic medication for this patient? Acetaminophen (Tylenol) PO Hydromorphone HCl (Dilaudid) IM Morphine sulfate PCA Transdermal fentanyl (Duragesic) Question 20 1 / 1 pts Which patient may require a higher than expected dose of an opioid analgesic? A patient with cancer A patient with a concussion A patient with hypotension A patient 3 days after surgery Question 21 1 / 1 pts The nurse is caring for a patient who is receiving diphenhydramine (Benadryl). The nurse notes that the patient has not voided for 12 hours. What action will the nurse take? Encourage the patient to drink more fluids. Evaluate the bladder to check for distension. Request an order for an intravenous fluid bolus. Request an order for urinary catheterization. Question 22 1 / 1 pts A patient is admitted to the hospital after developing pneumonia. During the admission assessment, the patient reports having used a nasal decongestant spray Phenylephrine (NeoSynephrine) for the past few weeks but thinks the nasal congestion is getting worse. The nurse will Request an order for a systemic decongestant medication. Request an order so the patient can continue to use the decongestant spray. Tell the patient the medication will cause nasal congestion. Tell the patient to increase oral fluid intake. Question 23 1 / 1 pts The nurse is providing teaching for a patient who will use intranasal dexamethasone (Decadron) after discharge home from the hospital. What information is important to include when teaching this patient about this drug? “Dexamethasone may be used for year-round symptoms.” “Dexamethasone should be discontinued after 30 days.” “Dexamethasone should not be taken with antihistamines.” “Dexamethasone should not cause systemic steroid side effects.” Question 24 A patient with chronic obstructive pulmonary disease (COPD) who has a persistent nonproductive cough asks about a medication that will not cause sedation. The nurse will encourage the patient to discuss which medication with the provider? Dextromethorphan hydrobromide (Benylin DM) Guaifenesin and codeine Promethazine with dextromethorphan Benzonatate HCl (Tessalon Perles) Question 25 1 / 1 pts A patient who has a nonproductive cough will begin taking guaifenesin (Robitussin) to help with secretions. When teaching this patient about the medication, the nurse will provide which instruction? “Avoid driving or using heavy machinery.” “Drink extra water while taking the medication.” “Monitor urine output closely.” “Take with an oral antihistamine for better effects.” Question 26 1 / 1 pts A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What information will the nurse include when teaching this patient about this medication? Failure to respond to the medication indicates a need for a higher dose. Monitor for hypoglycemia symptoms when using this medication. Palpitations are common with this drug even at normal, therapeutic doses. Overuse of this medication can result in a collapsed lung. Question 27 1 / 1 pts A patient will begin using albuterol (Proventil), and an inhaled glucocorticoid medication (steroid) to treat chronic bronchitis. When teaching this patient about disease and medication management, the nurse will instruct the patient to administer these medications in which order? Albuterol 5 minutes prior to steroid Albuterol followed in 4 hours with the steroid Alternate steroid with albuterol every other day Steroid 5 minutes prior to albuterol Question 28 1 / 1 pts The nurse is teaching a patient who will begin taking oral theophylline (Theo-Dur) when discharged home from the hospital. What information will the nurse include when teaching the patient about this drug? An extra dose should be taken when symptoms worsen. Anorexia and gastrointestinal upset are unexpected side effects. Avoid caffeine while taking this medication. Food will decrease the amount of drug absorbed. Question 29 1 / 1 pts The nurse is caring for a patient who is receiving intravenous theophylline. The patient complains of headache and nausea. The nurse will contact the provider to Change the medication to an oral theophylline. Obtain an order for a serum theophylline level. Request an order for an analgesic medication. Suggest an alternative methylxanthine medication. Question 30 1 / 1 pts Which statement about dextromethorphan (Benylin) does the nurse identify as being true? It is a narcotic antitussive It suppresses the cough center of the medulla It suppresses respirations It causes physical dependence Question 31 1 / 1 pts The nurse provides teaching for patient who will begin taking montelukast sodium (Singular) a leukotriene receptor antagonist. Which statement by the patient indicates a need for FURTHER teaching? “I will need to have periodic laboratory tests while taking this medication.” “I will not take ibuprofen for pain or fever while taking this drug.” “I will take one tablet daily at bedtime.” “I will use this as needed for acute symptoms.” Question 32 1 / 1 pts A patient who uses an inhaled glucocorticoid medication reports having a sore tongue. The nurse notes white spots on the patient’s tongue and oral mucous membranes. After notifying the provider, the nurse will remind the patient to perform which action? Avoid using a spacer with the inhaled glucocorticoid medication. Clean the inhaler with hot, soapy water after each use. Consume yogurt daily while using this medication. Rinse the mouth thoroughly with water after each use. Question 33 1 / 1 pts A patient will begin using an albuterol metered-dose inhaler to treat asthma symptoms. The patient asks the nurse about the difference between using an oral form of albuterol and the inhaled form. The nurse will explain that the inhaled form of albuterol Has a more immediate onset than the oral form. May cause more side effects than the oral preparation. Requires an increased dose in order to have therapeutic effects. Will not lead to tolerance with increased doses. Question 34 1 / 1 pts A patient is brought to the emergency department and reports having taken “a lot” of acetaminophen extra-strength tablets 16 hours prior. The nurse will expect the provider to order Acetylcysteine (Mucomyst). Dornase alfa (Pulmozyme). Gastric lavage. Renal enzyme tests. Question 35 1 / 1 pts A patient has been diagnosed with the common cold. The nurse should question if which drug is ordered to treat this patient? Antihistamines Antitussives Expectorants Antibiotics Question 36 1 / 1 pts A patient with chronic obstructive pulmonary disease asks the nurse what the albuterol (Proventil) he is taking does. The nurse should inform the patient that albuterol is used to Mobilize respiratory secretions. Decrease the cough response. Increase the work of breathing. Dilate the larger airways. Question 37 1 / 1 pts When a patient is receiving long term NSAID therapy, which drug may be given to prevent serious gastrointestinal adverse effects of NSAIDS? Metoprolol (Lopressor) Metoclopramide (Reglan) Magnesium sulfate Misoprostol (Cytotec) Question 38 1 / 1 pts A patient who received a bronchodilator 20 minutes ago now has all the following responses. For which one do you notify the prescriber Change in oxygen saturation from 89% to 95%. Bad taste in the mouth. Chest pain on exertion. Dryness of the mouth and throat. Question 39 1 / 1 pts A home care nurse is visiting a patient with asthma who suddenly experiences an acute asthma attack. Which drug should the nurse prepare to administer? Afirlukast (Accolate) Nedrocromil sodium (Tilade) Albuterol (Proventil) Zileuton (Zyflo) Question 40 1 / 1 pts A patient received morphine sulfate for severe pain. The nurse assesses the patient 20 minutes later. What is the best indication that the medication has been effective? Patient verbalizes pain relief. Patient has an increase in heart rate. Patient is resting. Patient has an increase in blood pressure. Question 41 1 / 1 pts The nurse identifies which of the following as a common side effect/adverse effect of morphine therapy? Diarrhea Hypertension Urinary retention Tachypnea Question 42 1 / 1 pts Which herb is associated with the development of bleeding if taken with nonsteroidal antiinflammatory drugs? Garlic Echinacea 1 / 1 pts A patient taking an OTC cold medicine and an OTC allergy medicine is found to be taking a double dose of pseudoephedrine (Sudafed). As a result, the patient might exhibit: Ear pain and eye redness. Restlessness and palpitations. Sinus pressure. An irritating cough. Question 44 1 / 1 pts A patient is using an albuterol inhaler for a rescue treatment for asthma. The nurse monitors the patient’s heart rate and finds an increase from 70 bpm to 86 bpm within 5 minutes of using the inhaler. What is the nurses best response? Notify the prescriber. Apply PRN oxygen by mask. Raise the head of the bed to 45 degrees. Document the change as the only action. Question 45 1 / 1 pts Which medication is a first-generation antihistamine? Cetirizine (Zyrtec) Fexofenadine (Allegra) Diphenhydramine (Benadryl) Loratadine (Claritin) Question 46 1 / 1 pts Before administering diphenhydramine (Benadryl) to a patient, it is important for the nurse to assess the patient for a history of: Allergy to penicillin. Hypertension Diabetes type-2 Narrow-angle Glaucoma Question 47 1 / 1 pts A patient with gout is prescribed colchicine. It is most important for the nurse to give which instruction to the patient? Take colchicine 2 hours before meals Increase vitamin C intake. Avoid alcohol and caffeine. Increase foods high in purines. Question 48 1 / 1 pts A patient is ordered to receive low-dose aspirin (ASA) to prevent a heart attack. Which assessment, if found in the patient, is the highest priority for the nurse? Otitis externa Multiple bruises Dry mouth Aches in the joints Question 49 1 / 1 pts The nurse assesses a patient receiving morphine via a PCA pump. The patient has a respiratory rate of 6 breaths/min. The nurse anticipates administration of which of the following drugs? Hydromorphone (Dilaudid) Nalbuphine HCl (Nubain) Naloxone (Narcan) Sumatriptan (Imitrex) Question 50 1 / 1 pts When teaching a patient about use of nasal decongestant sprays, the nurse informs the patient that they are most effective when administered for how many days? 5 days 10 days 14 days 20 days Question 51 1 / 1 pts The nurse is preparing a class for patients with asthma. The nurse will inform the patients that leukotriene modifiers (Singulair) are used in the treatment of asthma to: prevent serious complications from bacterial infections. Loosen mucus from the airways. Suppress the release of histamine and other mediators from the mast cells. Assist in opening narrowed airways.