NURS 6521 ADVANCE PHARM FINAL STUDY QUESTIONS

Glucocorticoids can cause osteoporosis, diabetes, weight gain --Give Biphosphontate if using for log term-- ED medication side effects hearing problems, HTN when administered with Nitrates Flomax (tamsulosin) can treat Pulmonary HTN and BPH Testosterone S.E Edema, hepatoxicity, decreases HDL, increases LDL, prostate CA, abuse potential Rickets treatment Vitamin D, Calcium, and Doxycycline Alcoholics have what type of vitamin deficiency Folic Acid, Thiamin B1 Glucosamine is used to treat Osteoarthritis -there is an increased risk for bleeding- A male patient is trying to decide if he should use finasteride (Proscar) to treat BPH. When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy? Prostate CA A male patient is experiencing climacteric symptoms secondary to androgen deficiency. His physician has prescribed testosterone. The nursing assessment reveals that the patient has had a myocardial infarction. The combination of testosterone therapy and a history of myocardial infarction would place that patient at a significantly higher risk of hypercholesterolemia. A Nurse Practitioner is performing patient education for a woman who has just been prescribed biphosphonate. Which of the following diagnostic and history findings would have prompted the woman's care provider to prescribe a biphosphonate Low bone density and a family history of osteoporosis A 16 year old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient? Take the drug for 1 full week before coming in contact with allergens. A Nurse Practitioner is reviewing the pre pregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of which of the following changes in pharmacokinetics that accompanies pregnancy? Increased drug distribution resulting from hemodynamic changes Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by slowing the infusion A Nurse Practitioner is working with a 16 year old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is whether the pregnant woman uses illegal substances. A Nurse Practitioner will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months? Liver function tests A 29 year old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for the patient is? Anxiety related to the perceived danger of drug therapy to fetus or infant A Nurse Practitioner is caring for a patient who is on amphotericin B. On morning rounds the patient reports weakness, numbness, and a tingling sensation in his feet. What would be a priority action by this nurse? Keep the bed in a low position and the side rails up at all times A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in? Iron-Rich food such as beans and leafy green vegetables On the advice of her sister, a 52 year old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate? "It's important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke" 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 caffeine 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 Schedule II An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions? Prime the IV tubing with an approved IV solution rather than with the drug itself. Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim? Do you feel like you're having any pain in your bones A 6 month old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? Compared to adult skin, infants' skin exhibits greater permeability. This can result in increased absorption, which may result in adverse effects that usually do not occur in the adult. Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen? Headaches and chest pain Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42 year old patient when providing education to the patient and his wife, the nurse should inform the wife about which of the following adverse effects? Vaginal Burning A Nurse Practitioner is explaining to the parents of a 6 year old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation? A child has a greater body surface area creating greater permeability, resulting in an increase in absorption of topical agents, which may result in more adverse effects A 36 year old patient comes to the clinic and tells the nurse practitioner that she suspects that she is pregnant. During the initial assessment, the nurse practitioner learns that the patient is currently taking medications for diabetes, hypertension, and seizure disorder. The nurse would be most concerned about which of the following medications? Phenytoin (Dilantin) 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? Discard the unused portion of the drug An elderly woman is slated for a hemiarthrosplasty (hip replacement surgery) after falling and breaking hr hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain? Twice daily dose of long-acting morphine, with short-acting morphine available for breakthrough pain A nurse practitioner has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug? a 19-year-old male receiving radiotherapy A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication With high-fat meals A man has a demonstrated history of androgen deficiency and the consequences of his health problem include an inability to maintain an erection. Which of the following medications would best address this patient's erectile dysfunction (ED)? Exogenous testosterone A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective? The patient's hemoglobin level is 11 g/dL A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose? 2000mg A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient's drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond? Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on The permeability of fungal cell walls A 62 year old patient taking tamoxifen exhibits increased bone and tumor pain along with a local disease flare. The nurse interprets this as an indication of which of the following? The tumor responding to treament A 19 year old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonads vaginalis. The nurse practitioner is aware that asymptomatic women are diagnosed with trichomoniasis by routine pap smear A 72 year old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug? Lid margin crusting and pruritus A 7 year old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug with a glass of water 1 hr before or 2 hrs after a meal The Nurse Practitioner has established peripheral IV access and begun an infusion of magnesium sulfate on a 29 year old antepartum patient who is 35 weeks pregnant. Which of the following assessment findings most likely prompted the patient's physician to order magnesium sulfate for this patient? Systolic blood pressure readings in excess of 190 mmHg A patient has acquired primary hypogonadism and has been prescribed testoster9ne transdermal (Androderm) patches. When educating the patient on how to administer the drug, the nurse will instruct him to place the patch on the back, abdomen, upper arms, or thighs A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as magnesium sulfate toxicity A Nurse Practitioner is assigned to a patient who is a 32 weeks' gestation and is receiving terbutaline (Brethine) IV for 24 hours to control preterm labor. Which of the following nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus? Instruct the patient to lie on her left side during the infusion A 71 year old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicate a need for this drug? "Lately, I have to get up three or four times a night to go to the bathroom." Mr. Lepp is a 63 year old man who was diagnosed with colon cancer several weeks ago and who 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? The potential benefits of epetin alfa must be weighed carefully against the potential adverse effects in cancer patients. Sulconazole has been prescribed for a patient with tine pedis. The nurse will instruct the patient to use the topical agent once a day An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs? Cells that have a rapid mitotic rate