ECPI NUR 138 PHARMACOLOGY EXAM 1 (LATEST) QUESTIONS WITH COMPLETE ACTUAL SOLUTIONS!!, Exams of Pharmacology

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ECPI NUR 138

PHARMACOLOGY

EXAM 1 (LATEST)

QUESTIONS WITH

COMPLETE ACTUAL

Evatee 9/28/24 EPIC NUR 138

ECPI NUR 138 PHARMACOLOGY EXAM 1

(LATEST) QUESTIONS WITH COMPLETE

ACTUAL SOLUTIONS!!

The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent? A. "Right route" B. "Right medication" C. "Right dose" D. "Right time" Answer - D. "Right time" Rationale: "Right time" is correct because the medication was given more than 30 minutes after the scheduled dose was due. "Dose" is incorrect because the dose is not related to the time the medication administration is scheduled. "Route" is incorrect because the route is not affected. "Medication" is incorrect because the medication ordered will not change. The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs? A. Parenteral drugs bypass the first-pass effect. B. Absorption of parenteral drugs is affected by reduced blood flow to the stomach. C. Absorption of parenteral drugs is faster when the stomach is empty. D. Parenteral drugs exert their effects while circulating in the bloodstream. Answer - A. Parenteral drugs bypass the first-pass effect.

Rationale: Of the types of oral medications listed, the powder form would be absorbed the fastest, thus having a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet would be absorbed next, in that order. Which drugs would be affected by the first-pass effect? (Select all that apply.) A. Sublingual nitroglycerin tablets B. Levothyroxine (Synthroid) tablets C. Diphenhydramine (Benadryl) elixir D. Penicillin given by IV piggyback infusion E. Morphine given by IV push injection F. Esomeprazole (Nexium) capsules G. Transdermal nicotine patches Answer - B. Levothyroxine (Synthroid) tablets C. Diphenhydramine (Benadryl) elixir F. Esomeprazole (Nexium) capsules For accurate medication administration to pediatric patients, the nurse must take into account which criteria? A. Renal output B. Height C. Body temperature D. Organ maturity Answer - D. Organ maturity Rationale: To administer medications to pediatric patients accurately, one must take into account organ maturity, body surface area, age, and weight. The

other options are incorrect: renal output and body temperature are not considerations, and height alone is not sufficient. During discharge patient teaching, the nurse reviews prescriptions with a patient. Which statement is correct about refills for an analgesic that is classified as Schedule C-III? A. The patient may have no more than five refills in a 6-month period. B. Refills are allowed only by written prescription. C. Written prescriptions expire in 12 months. D. No prescription refills are permitted. Answer - A. The patient may have no more than five refills in a 6-month period. Rationale: Schedule C-III medications may be refilled no more than five times in a 6-month period. The patient should be informed of this regulation. No prescription refills are permitted for Schedule C-II drugs. Requiring refills by written prescription only applies to Schedule C-II drugs. Schedule C-III prescriptions (written or oral) expire in 6 months. The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects? A. The patient should be discouraged from using folk remedies and rituals. B. The nurse will remember that the balance among body, mind, and environment is important for this patient's health beliefs. C. The nurse will expect the patient to value protective bracelets and "root workers" as healers. D. The nurse's assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing. Answer - D. The nurse's assessment needs to include gathering information

reaction because he has renal problems, which was a contraindication to that drug. The nurse may be liable for which of these? A. Nonmaleficence B. Medical negligence C. Autonomy D. Nursing negligence Answer - D. Nursing negligence Rationale: Negligence is the failure to act in a reasonable and prudent manner or failure of the nurse to give the care that a reasonably prudent (cautious) nurse would render or use under similar circumstances. In this case, nursing negligence applies to nurses, not medical negligence. Nonmaleficence is defined as the duty to do no harm. Autonomy is defined as the right to make one's own decisions, or self-determination. The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the dose of the drug ordered? A. Digoxin 0.1250 mg B. Digoxin .125 mg C. Digoxin .1250 mg D. Digoxin 0.125 mg Answer - D. Digoxin 0.125 mg Rationale: Digoxin 0.125 mg illustrates the correct notation with a leading zero before the decimal point. Omitting the leading zero may cause the order to be misread, resulting in a large drug overdose. Digoxin .125 mg and digoxin. mg do not have the leading zero before the decimal point. Digoxin 0.1250 mg has a trailing zero, which also is incorrect.

The nurse can prevent medication errors by following which principles? (Select all that apply.) A. Use trade names instead of generic names to avoid confusion. B. Assess for allergies after giving medications. C. Minimize the use of verbal and telephone orders. D. Use two patient identifiers before giving medications. E. Do not give a medication that another nurse has drawn up in a syringe. Answer - C. Minimize the use of verbal and telephone orders. D. Use two patient identifiers before giving medications. E. Do not give a medication that another nurse has drawn up in a syringe. Rationale: Measures that prevent medication errors include using two patient identifiers, giving only medications that you have drawn up or prepared, and minimizing the use of verbal and telephone orders. Assessment for allergies should be done before medications are given. Generic names should be used to avoid the many sound-alike trade names of medications. A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing? A. Neuropathic pain B. Chronic pain C. Somatic pain D. Acute pain Answer - B. Chronic pain

Rationale: One of the most serious adverse effects of opioids is respiratory depression. The nurse must assess the patient's respiratory rate before administering an opioid. The other options are incorrect. A patient has been treated for lung cancer for 3 years. Over the past few months, the patient has noticed that the opioid analgesic is not helping as much as it had previously and more medication is needed for the same pain relief. The nurse is aware that this patient is experiencing which of these? A. Opioid toxicity B. Opioid addiction C. Opioid tolerance D. Opioid abstinence syndrome Answer - C. Opioid tolerance Rationale: Opioid tolerance is a common physiologic result of long-term opioid use. Patients with opioid tolerance require larger doses of the opioid agent to maintain the same level of analgesia. This situation does not describe toxicity (overdose), addiction, or abstinence syndrome (withdrawal). The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew? A. Migraine headaches B. Incision pain after surgery C. Leg cramps D. Muscle aches Answer - A. Migraine headaches Rationale: Feverfew is commonly used for migraine headaches, menstrual problems, arthritis, and fever. Possible adverse effects include muscle stiffness and muscle and joint pain.

A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse expects that the patient is receiving this drug for which condition? A. Depression associated with chronic pain B. Prevention of seizures C. Pain associated with peripheral neuropathy D. Inflammation pain Answer - C. Pain associated with peripheral neuropathy Rationale: Anticonvulsants are often used as adjuvants for treatment of neuropathic pain to enhance analgesic efficacy. The other indications listed are not correct. The drug nalbuphine (Nubain) is an agonist-antagonist (partial agonist). The nurse understands that which is a characteristic of partial agonists? A. They have a higher potency than agonists. B. They are given to reverse the effects of opiates. C. They have anti-inflammatory effects. D. They have a lower dependency potential than agonists. Answer - D. They have a lower dependency potential than agonists. Rationale: Partial agonists such as nalbuphine are similar to the opioid agonists in terms of their therapeutic indications, however, they have a lower risk of misuse and addiction. They do not have anti-inflammatory effects, nor are they given to reverse the effects of opiates. They do not have a higher potency than agonists.

Rationale: Corticosteroids have an anti-inflammatory effect, which may help to reduce pain. The other medications do not have anti-inflammatory properties. The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems? A. Sympathetic nervous system B. Central nervous system C. Somatic nervous system D. Parasympathetic nervous system Answer - A. Sympathetic nervous system Rationale: Adrenergic drugs mimic the effects of the sympathetic nervous system. When a patient is taking an adrenergic drug, the nurse expects to observe which effect? A. Constricted pupils B. Increased heart rate C. Increased intestinal peristalsis D. Bronchial constriction Answer - B. Increased heart rate Rationale: Increased heart rate is one of the effects of adrenergic drugs. Sympathetic nervous system stimulation also results in bronchodilation, dilated pupils, and decreased gastrointestinal mobility, depending upon which receptors are stimulated.

An adrenergic agonist is ordered for a patient in shock. The nurse will note that this drug has had its primary intended effect if which expected outcome occurs? A. Volume restoration B. Increased cardiac output C. Reduced anxiety D. Decreased urine output Answer - B. Increased cardiac output Rationale: For a patient in shock, a primary benefit of an adrenergic agonist drug is to increase cardiac output. A drug in this category should not be used in place of volume restoration, nor does it provide volume restoration (IV fluids do this). Adrenergic agonists may enhance urine output if cardiac output and perfusion to the kidneys increase. These drugs do not reduce anxiety. Question 25 A 14-year-old patient has been treated for asthma for almost 4 months. Two weeks ago, she was given salmeterol as part of her medication regimen. However, her mother has called the clinic to report that it does not seem to work when her daughter is having an asthma attack. Which response by the nurse is appropriate? A. "It takes time for a therapeutic response to develop." B. "She is too young for this particular medication; it will be changed" C. "She needs to take up to two puffs every 4 hours to ensure adequate blood levels." D. "This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms." Answer - D. "This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms."

A patient is going home with a new prescription for the beta-blocker atenolol (Tenormin). The nurse will include which content when teaching the patient about this drug? A. The medication will be stopped once symptoms subside. B. If adverse effects occur, stop taking the drug for 24 hours, and then resume. C. Be watchful for first-dose hypotension. D. Never stop taking this medication abruptly. Answer - D. Never stop taking this medication abruptly. Rationale: Patients need to be weaned off these medications slowly because rebound hypertension and chest pain are possible with abrupt withdrawal. The drugs should never be stopped abruptly nor doses skipped. First-dose hypotension occurs with alpha blockers. During initial rounds, the nurse notes that a dobutamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine (Regitine) subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in this situation? A. It increases peripheral vascular resistance and reduces arterial pressure at the site. B. It increases blood flow to the ischemic site by vasodilation to prevent tissue damage. C. It neutralizes the extravasated dobutamine immediately. D. It causes arterial vasoconstriction and reduced pain and swelling at the site. Answer - B. It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.

Rationale: Phentolamine is an alpha blocker that reduces peripheral vascular resistance when given systemically, but local subcutaneous injection around the site of extravasated vasoconstrictive drugs, such as dobutamine, causes an alpha-adrenergic receptor blockade and vasodilation. This allows for increased blood flow to the ischemic tissue and may prevent permanent tissue damage. The teaching for a patient who is taking tamsulosin (Flomax) to reduce urinary obstruction due to benign prostatic hyperplasia will include which of these? A. Get up slowly from a sitting or lying position. B. Fluids need to be restricted while on this medication. C. Blood pressure must be monitored because the medication may cause hypertension. D. Take the medication with breakfast to promote the maximum effects of the drug. Answer - A. Get up slowly from a sitting or lying position. Rationale: This medication is used to relieve impaired urinary flow in men with benign prostatic hyperplasia, but it also can cause orthostatic hypotension when changing positions from sitting or lying positions. Because of these effects, the blood pressure may become dramatically lowered, and lightheadedness may occur, increasing the risk of falling. The nurse is screening a patient who will be taking a nonspecific/nonselective beta blocker. Which condition, if present, may cause serious problems if the patient takes this medication? A. Hypertension B. Asthma C. Angina D. Glaucoma Answer - B. Asthma

B. Impotence C. Urge incontinence D. Dizziness when standing up Answer - B. Impotence Rationale: Impotence is a potential adverse effect of beta blockers and may cause patients to stop taking the medication. The other options are not adverse effects of beta blockers. A patient has a new prescription for tamsulosin (Flomax) as treatment for benign prostatic hyperplasia. The nurse is checking his current medication list and will contact the prescriber regarding a potential interaction if the patient is also taking which drug? A. Levothyroxine (Synthroid) for hypothyroidism B. Low-dose aspirin for stroke prevention C. Sildenafil (Viagra), an erectile dysfunction medication D. Omeprazole (Prilosec), a proton pump inhibitor Answer - C. Sildenafil (Viagra), an erectile dysfunction medication Rationale: Drugs that interact with alpha blockers such as tamsulosin include erectile dysfunction drugs: additive hypotensive effects may occur. The other drugs do not interact with tamsulosin. A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effect? A. Discolored urine B. Increased blood pressure C. Orthostatic hypotension

D. Decreased urine flow Answer - C. Orthostatic hypotension Rationale: Orthostatic hypotension can occur with any dose of an alpha blocker, and patients must be warned to get up slowly from a supine position. The other responses are not drug effects of alpha blockers. When monitoring a patient who is taking a low-dose cholinergic drug, the nurse will watch for which cardiovascular effect? A. Palpitations B. Bradycardia C. Vasoconstriction D. Tachycardia Answer - B. Bradycardia Rationale: The cardiovascular effects of low doses of cholinergic drugs are decreased heart rate (not tachycardia) and vasodilation. Palpitations are not effects of cholinergic drugs. The nurse notes in a patient's medication history that the patient is taking pilocarpine (Pilocar). Based on this finding, the nurse interprets that the patient has which disorder? A. Glaucoma B. Anticholinergic poisoning C. Bladder atony D. Myasthenia gravis Answer - A. Glaucoma