NURS 6521 Advanced Pharmacology FINAL Exam Walden 2024

NURS 6521 ADVANCED PHARMACOLOGY FINAL EXAM Question 1: A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him which of the following? Answer: "You might find that your face becomes flushed, or you get a headache after taking Viagra." - Question 2: A patient takes etoposide for a testicular tumor refractory treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor which of the following? - ANSWER- Answer: Elevated prothrombin time - Question 3: A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient - Answer: to complete the entire course of drug therapy. – Question 4: Drugs have a valid medical use but a high potential for psychological and physiologic abuse. In an emergency, a Schedule II drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. These are scheduled drugs - ANSWERAnswer: Schedule II Question 5: A 16-year-old boy has been prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the drug's therapeutic effects, which of the following will the nurse include in instructions to the patient? Answer: Take the drug for one whole week before coming in contact with allergens Question 6: A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is sweating, and her BP is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as Answer: Magnesium Sulfate toxicity. - Question 7: A patient with a recent diagnosis of chronic myelogenous leukemia (CML) discusses treatment options with his care team. What aspect of the patient's condition would contraindicate the use of cyclophosphamide to treat leukemia? Answer: The patient's bone marrow function is significantly depressed. – Question 8: After six months of unsuccessfully trying to conceive, a 31 year-old woman and her husband have sought a referral to a fertility specialist to explore their options. A nurse at the clinic should recognize that the woman may benefit from - Answer: clomiphene. Question 9: A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids regularly. The nurse will instruct the patient: Answer: to take antacids not less than 1 hour before or 2 hours after taking INH. Question 10: A Nurse Practitioner working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using Answer: Body Surface Area Question 11: An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL), and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient's current health status may preclude the use of imatinib? - Answer: The patient has chronic heart failure resulting in significant peripheral edema Question 12: A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic hypertrophy (BPH). When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy? Answer: Prostatic neoplasia Question 13: A Nurse Practitioner will instruct a patient taking allopurinol to take each dose Answer: After a meal. Question 14: A patient has acquired primary hypogonadism and was prescribed testosterone transdermal (Androderm) patches. When educating the patient on administering the drug, the nurse will instruct him to Answer: place the patch on the back, abdomen, upper arms, or thighs. - Question 15: A 66-year-old woman has experienced a significant decline in her quality of life due to worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is responsible for facilitating this new aspect of the patient's drug regimen involving the administration of Answer: weekly subcutaneous injections - Question 16: A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for recurrent cystitis. Because of the patient's history, the nurse would be sure to discuss the use of - Answer: food containing iron or calcium with the woman. Question 17: A Nurse Practitioner has questioned why a patient's physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug to treat a patient's infection. Which of the following facts provides the best rationale for using narrow-spectrum antibiotics whenever possible? - ANSWERAnswer: The use of broad-spectrum antibiotics can create a risk for a superinfection. - ANSWERQuestion 18: A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should - ANSWERAnswer: offer a choice between liquid and chewable medications, if possible. - ANSWERQuestion 19: Which of the following would a Nurse Practitioner assess for in a patient taking polymyxin B systemically? - ANSWERAnswer: Nephrotoxicity and hepatotoxicity - ANSWERQuestion 20: A woman is receiving prolonged drug therapy during her complicated pregnancy, and it may pose a risk to both the mother and the fetus. The primary care physician has made dosage adjustments to minimize adverse effects and prevent toxicity; The RN should ensure that - ANSWERAnswer: Drug serum levels are being monitored. - ANSWER- Question 21: A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to do which of the following? - ANSWERAnswer: Drink alot of water - ANSWERQuestion 22: A pregnant patient with diabetes has been admitted to the hospital to begin labor. Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor contractions. When talking to the patient about the adverse effects of the drug, the nurse should understand that the most common adverse effects of the drug include - ANSWERAnswer: uterine tachysystole. - ANSWERQuestion 23: A nurse practitioner has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following? - ANSWERAnswer: Respiratory difficulty - ANSWERQuestion 24: A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause - ANSWER- Answer: ototoxicity or nephrotoxicity - ANSWERQuestion 25: A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and requested a prescription for tadalafil (Cialis) based on television commercials. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED? - ANSWERAnswer: The patient has unstable angina and uses a nitroglycerin patch - ANSWERQuestion 26: A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of - ANSWERAnswer: Caffeine - ANSWERQuestion 27: A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize? - ANSWERAnswer: The patient will experience complete bladder emptying - ANSWER- Question 28: A Nurse Practitioner is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug? - ANSWERAnswer: Discard the unused portion of the drug. - ANSWERQuestion 29: A 36-year-old woman with a history of dysmenorrhea has begun treatment with progesterone, which she will be received by the intramuscular route. The nurse participating in the woman's care should prioritize which of the following potential nursing diagnoses? - ANSWERAnswer: Risk for Injury related to loss of vision or thrombotic events - ANSWERQuestion 30: A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? - ANSWERAnswer: Dietary habits - ANSWERQuestion 31: A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an - ANSWER- Answer: electrocardiogram (ECG). - ANSWERQuestion 32: Mr. Lepp is a 63-year-old man diagnosed with colon cancer several weeks ago and is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse's response to Mr. Lepp? - ANSWERAnswer: The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients - ANSWERQuestion 33: A Nurse Practitioner has completed a medication reconciliation of a patient admitted following a motor vehicle accident. Rituximab is among the many drugs the patient has received in the previous year. The nurse would be justified in suspecting the patient may have received treatment for the following diseases. - ANSWERAnswer: Non-Hodgkin's lymphoma - ANSWERQuestion 34: An oncology nurse is aware of the risk for injury related to the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks, the nurse should take the following actions? - ANSWER- Answer: Prime the IV tubing with an approved IV solution rather than the drug itself. - ANSWERQuestion 35: A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining - ANSWERAnswer: a baseline CBC - ANSWERQuestion 36: A 45-year-old woman with acute leukemia will begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered. - ANSWERAnswer: through a central line. - ANSWERQuestion 37: A patient takes rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that - ANSWERAnswer: body fluids such as urine, saliva, tears, and sputum may become discolored. - ANSWERQuestion 38: A 30-year-old woman in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye crusted with a purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? - ANSWERAnswer: The use of ciprofloxacin is contraindicated in pregnancy. - ANSWERQuestion 39: A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit? - ANSWERAnswer: Urinary elimination patterns - ANSWERQuestion 40: A 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain and a local disease flare. The nurse interprets this as an indication of which of the following? - ANSWERAnswer: The tumor is responding to treatment. - ANSWERQuestion 41: A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose? Answer: 2000 mg - ANSWERQuestion 42: A 56-year-old woman will soon begin treating her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman? - ANSWER- Answer: "You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued." - ANSWERQuestion 43: A patient is seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the injection site of the drug. The most likely cause of this response is: - ANSWERAnswer: an allergic response. - ANSWERQuestion 44: A 29-year-old pregnant patient is extremely upset about taking medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She constantly talks about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient? Answer: Anxiety related to the perceived danger of drug therapy to a fetus or infant. - ANSWERQuestion 45: A 15-year-old boy who has been taking dextroamphetamine to treat ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a severe risk of a health problems? - ANSWER- Answer: hypertensive crisis - ANSWERQuestion 46: A patient has been admitted to the hospital's critical care unit with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient's most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA). The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic? - ANSWERAnswer: vancomycin - ANSWERQuestion 47: A 73-year-old woman has osteoporosis and is prescribed alendronate. She takes calcium and vitamin D supplements, drinks lots of water, and has just quit smoking. The nurse should advise the patient. - ANSWERAnswer: perform light-weight exercises and go for walks. - ANSWERQuestion 48: A Nurse Practitioner is performing patient education for a woman who has just been prescribed bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman's care provider to prescribe a bisphosphonate? - ANSWERAnswer: Low bone density and a family history of osteoporosis - ANSWER- Question 49: A nurse practitioner provides patient education to a 50- year-old woman taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid the following drugs. - ANSWERAnswer: Salicylates - ANSWERQuestion 50: A Nurse Practitioner is caring for a patient at 28 weeks gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize? - ANSWERAnswer: Fetal Heart Rate (FHR) - ANSWERQuestion 51: A Nurse Practitioner educator who coordinates the staff education in an oncology unit conducts an in-service on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session? - ANSWERAnswer: Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected. - ANSWERQuestion 52: Laboratory testing has confirmed that a patient has chloroquine-resistant malaria, and the patient's physician has prescribed quinine and an adjunctive drug. The nurse should question the physician's order if the patient has a history of - ANSWERAnswer: cardiac arrhythmias. - ANSWER- Question 53: When planning care for a patient receiving filgrastim (Neupogen) for a non-myeloid malignancy, the nurse should formulate the following patient outcomes? (Select all that apply.) - ANSWERAnswer: The patient will not develop an infection; The patient will not experience bone pain; The patient will be able to self-administer filgrastim at home. The patient will not develop febrile neutropenia. - ANSWERQuestion 54: A 67-year-old man treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to - ANSWERAnswer: schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks. - ANSWERQuestion 55: A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide teaching medication specifically - ANSWERAnswer: to both the boy and his mother regarding all medication issued. - ANSWERQuestion 56: A Nurse Practitioner reviews the pre-pregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of the following changes in pharmacokinetics that accompany pregnancy? - ANSWERAnswer: Increased drug distribution resulting from hemodynamic changes - ANSWER . . . . . . . . .