NR 293 (PHARM) Final Exam Questions With Answers 2023/2024 Rated A+

NR 293 (PHARM) Final Exam Questions With Answers 2023/2024 Rated A+. A patient, newly diagnosed with hypothyroidism, receives a prescription for a thyroid hormone replacement drug. The nurse assesses for which potential contraindication to this drug? D. Recent myocardial infarction ANS: D Contraindications to thyroid preparations include known drug allergy to a given drug product, recent myocardial infarction, adrenal insufficiency, and hyperthyroidism..  Administration of antiemetics with chemotherapy treatment A patient is on a chemotherapy regimen in an outpatient clinic and is receiving a chemotherapy drug that is known to be highly emetogenic. The nurse will implement which interventions regarding the pharmacologic management of nausea and vomiting? (Select all that apply.) B. Administering antinausea drugs 30 to 60 minutes before chemotherapy is started E. Instructing the patient that the antinausea drugs may cause extreme drowsiness F. Instructing the patient to rise slowly from a sitting or lying position because of possible orthostatic hypotension ANS: B, E, F Antiemetics should be given before any chemotherapy drug is administered, often 30 to 60 minutes before treatment, but not immediately before chemotherapy is administered. Do not wait until the nausea begins. Most antiemetics cause drowsiness, not restlessness and anxiety. Orthostatic hypotension is a possible adverse effect that may lead to injury.  Administration of mannitol Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure? 1.Intravenously, through a filter ANS: A Mannitol is administered via intravenous infusion through a filter because of possible crystallization. It is not available in oral form. The other options are incorrect. For acute renal failure, osmotic diuretic A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure? C. Osmotic diuretics ANS: B Mannitol, an osmotic diuretic, is commonly used to reduce intracranial pressure and cerebral edema resulting from head trauma. The nurse will be giving ophthalmic drugs to a patient with glaucoma. Which drug is given intravenously to reduce intraocular pressure when other medications are not successful? D. Mannitol (Osmitrol) ANS: C Drugs used to reduce intraocular pressure include osmotic diuretics such as mannitol, which is given intravenously. Tobramycin and bacitracin are antibiotics; ketorolac has anti-inflammatory actions.  Adverse effects and interactions with lithium Most serious effect – cardiac dysrhythmia, long term treatment for hypothyroidism Others: drowsiness, slurred speech, epilepsy-type seizures, choreoathetotic movements, ataxia, hypotension Interactions: do not drastically change their sodium intake, and avoid overhydration or dehydration No anecdote, but mannitol will be given Lithium interacts with postassium –sparing diuretics 0.6 to 1.2 levels theraputic When reviewing the medication profile of a pt. With a new order for desmopressin (DDAVP) the nurse notes that a drug interaction will occur if which drug is taken with desmopressin? C. Lithium Lithium ay cause a decreased therapeutic effect of desmopressin.  Adverse effects of ACE inhibitors A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs? ACE inhibitors (lisinipro) Others: Fatigue, dizziness, headache, mood changes, impaired taste, possible hyperkalemia, Angioedema (rare but potentially fatal)  Adverse effects of albuterol Hypotension, Vascular headache, Tremor, palpitations will feel racing heart, jittery, do not use with MAOI, wheezing Short acting helps acute asthma attack  Adverse effects of antithyroid medications *Cardiac Dysrhythmia* Others: tachycardia, palpitations, angina, hypertension, insomnia, tremors, headache, anxiety, nausea, diarrhea, menstrual irregularities, weight loss, sweating, heat intolerance, fever When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse will monitor for which adverse effect? a. Decreased glucose levels b. Decreased white blood cell count c. Increased red blood cell count d. Increased platelet count ANS: B Antithyroid drugs may cause bone marrow suppression, resulting in agranulocytosis, leukopenia, thrombocytopenia, and other problems. The other options are incorrect.  Adverse effects of antivirals Table 40.2 Kills all cells including healthy cells Numerous and vary with each drug. Drug therapy may need to be modified because of adverse effects. Goal is to find the regimen that will best control the infection with a tolerable adverse effect profile. Medication regimens change during the course of the illness. A pt. Is taking a combination of an antiviral drugs as treatments for early stages of a viral infection. While discussing the drug therapy, the pt. Asks the nurse if they drugs will kill the virus. When answering the nurse keeps in mind which face about antiviral drugs? D. They may also kill healthy cells while killing viruses. They reproduce in human cells, selective killing is difficult. 11.Antibiotic for treatment for CRE: (Chapter 39) A patient has been diagnosed with carbapenemase-resistant Enterobacteriaceae (CRE). The nurse expects to see orders for which drug? D. Colistimethate sodium (Coly-Mycin), a polypeptide antibiotic ANS: D Colistimethate (Coly-Mycin), commonly referred to as colistin, is now being used again, often as one of the only drugs available to treat CRE. The other options are incorrect. 12.Black box warnings are used for what? The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs? a. Increased risk of suicidal thoughts and behaviors In December 2008, the U.S. Food and Drug Administration (FDA) required black box warnings on all antiepileptic drugs regarding the risk of suicidal thoughts and behaviors. Patients being treated with antiepileptic drugs for any indication need to be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior. The other options are incorrect. Black box on all Quinolones; due to the cause of tendonitis and tendon rupture. Ribavirin aerosol treatment is harmful to pregnancy, due to teratogenic effects. If pt. Is receiving treatment, the pregnant health care provider should leave the room. Black box warning long acting opioids 13.Bone marrow suppression and early s/s of infection The nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy. Which is considered a principal early sign of infection? a.Fever b.Diaphoresis c.Tachycardia d.Elevated white blood cell count ANS: A Fever and/or chills may be the first sign of an oncoming infection. Elevated white blood cell count will not occur because of the bone marrow suppression. Patient is getting a high dose of methotrexate, what would you anticipate giving along-side of this? Leucovorin Rescue- decreases bone marrow suppression. 14.Calculations of pediatric dosages of opioids When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations? d. Milligram per kilogram of body weight formula ANS: D The milligram per kilogram formula, based on body weight, is the most common method of calculating doses for pediatric patients. The other options are available methods but are not the most commonly used. Height-to-weight ratio is not used. 15.Chemoreceptor trigger zone, vomiting center, and antiemetics Chemoreceptor (CTZ) -the area of the brain that is involved in the sensation of nausea and the action of vomiting. Vomiting center - the area of the brain that is involved in stimulating the physiologic events that lead to nausea and vomiting. Antiemetics – drugs given to relieve nausea and vomiting. Example ondansetron (Zofran) Hydroxyzine (Vistaril) antihistamine for nausea, Dronabinol (Marinol) stimulates appetite for AIDS pt. Medulla vomiting center, inner ear labyrinth, GI track trigger zones and cerebral cortex. 16.Classes of drugs that are CNS stimulants (Ch 13) (Chemical structural similarities, amphetamines, serotonin agonists, sympathomimetics, xanthines) The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.) a.Narcolepsy