Pharm II HESI

Pharm II HESI Which of the following is a rapid acting insulin and should be administered immediately before a meal? A. Glargine B. Aspart (Lispro) C. NPH D. Regular Ans- B. Aspart rationale: onset is 5 minutes Glargine=Lantus (long lasting) A PT has an anaphylactic allergy to sulfa drugs. She receives sulfamethoxazole. She becomes flushed and SOB. Her HR is normal but her BP is dropping. You first administer A. Epinephrine B. Diphenhydramine C. Albuterol D. Atropine Ans- A. Epi rationale: raises BP Which of the following would be an adverse effect of methimazole (Tapazole) A. Tachycardia B. Bradycardia C. SOB D. Arrhythmias Ans- This is an anti-thyroid medication B. Bradycardia One of your PTs is started on verapamil (Calan). Before administering the dose you check A. HR B. urine output C. weight D. temp Ans- this is a calcium channel blocker--worried about HR A. HR One of your PTs is to be started on iron sulfate therapy. You instruct him to: A. take with meals B. take on empty stomach C. remain upright for at least 60 min following administration D. take with vitamin A to increase absorption Ans- B. take on empty stomach rationale: taking with food lessens absorption, but it can cause upset stomach so most like to take with food take iron with vitamin C to increase absorption liquid iron-drink through straw bc it can stain teeth black which of the following should be considered when administering IV potassium? A. Max rate infused through central line is 20 meq/h B. Max rate infused through peripheral line is 10 meq/h C. Max concentration through a central line is 20 meq/50ml D. Max concentration through peripheral line is 10 meq/100ml E. all of the above Ans- E. all of the above will usually be infused peripherally which is the following agents is used to treat MG A. Atropine (anticholinergic) B. Pyridostigmine (Mestinon-acetylcholinesterase inhibitor) C. Metoprolol (Lopressor-beta blocker) D. Albuterol (Proventil-beta 2 agonist) Ans- B. Pyridostigmine rationale: Atropine is emergency drug for bradycardia which of the following would you monitor for patients started on a narcotic like morphine? A. HR B. respiratory rate C. liver function tests D. creatine phosphokinase (CPK) Ans- A. HR PT is receiving baclofen (Lioresal). This medication can cause A. sedation B. seizures C. none of the above D. all of the above Ans- this is a skeletal muscle relaxer A. sedation rationale: seizures can happen if you discontinue this med PT is started on orlistat (Xenical, Alli). You identify that this medication A. is a lipase inhibitor used to treat diabetes B. is a lipase inhibitor used to treat obesity C. is a lipase inhibitor used to increase muscle mass D. is a lipase inhibitor used to lower cholesterol Ans- B. lipase inhibitor used to treat obesity rationale: this is an anorexiant drug One of your PTs receives vancomycin at 12 every day. It takes 90 min to administer the entire dose. What time should a trough be drawn? A. 1230 B. 1400 C. 1130 D. 1300 Ans- C. 1130 rationale: if you have to choose between 1130 and 1200 pick 12 bc it should be immediately before which of the following agents reduce mortality in HF? A. Carvedilol (Coreg) B. Lisinopril (Prinivil) C. Aldactone (Spironolactone) D. all of the above Ans- D. all of the above rationale: Coreg-beta blocker Lisinopril-ACE inhibitor Aldactone-K+ sparing diuretic A PT is receiving rosuvastatin (Crestor). You can assess efficacy by seeing A. a reduction in HDL B. a reduction in LDL C. an increase in LDL D. an increase in VLDL Ans- B. reduction in LDL rationale: Crestor reduces LDL cholesterol A PT is receiving prasugrel (Effient). One potential adverse effect is A. black tarry stools B. heparin induced thrombocytopenia C. ischemic stroke D. HTN Ans- A. black tarry stools rationale: this is a blood thinner (platelet aggregate inhibitor) One of your PTs presents with a hypertensive emergency. Which of the following agents can be given to treat this? A. IV nitroglycerin B. oral furosemide (Lasix) C. oral hydrochlorothiazide (Microzide) D. oral midodrine (ProAmatine) Ans- A. IV nitro rationale: this is a vasodilator Midodrine-increases BP Lasix-also decreases HTN but wouldn't work as fast bc its oral not IV PT will complain of headache-make sure you don't touch the med if its a cream One of your PTs is on furosemide (Lasix) therapy. Which of the following monitoring parameters do you recommend? A. look for increase in urine output B. look for electrolyte disturbances like hyponatremia and hypokalemia C. look for decrease in weight D. all of the above Ans- D. all of the above a PT is given a dose of succinylcholine. You can expect to see the following A. skeletal muscle relaxation B. respiratory depression C. paralysis D. all of the above Ans- D. all of the above rationale: this causes paralysis-used for intubating or anesthesia