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A series of multiple-choice questions and answers covering various aspects of pharmacology, including drug mechanisms, clinical applications, and patient management. It provides a comprehensive review of key concepts and principles related to drug administration, pharmacokinetics, pharmacodynamics, and drug interactions. The questions are designed to assess understanding of drug classifications, therapeutic uses, adverse effects, and nursing considerations. This resource is valuable for students and professionals seeking to enhance their knowledge and understanding of pharmacology.
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Question 1 A client’s serum protein and albumin levels are below normal values. For a drug that is highly protein- bound, there would be: Answers: 1. more drug bound to protein
A client is taking a drug that is highly protein-bound. Several days later, the client takes a second drug that is 50% protein-bound. What happens to the first drug that is moderately highly protein-bound? Answers:
A client is suffering from end-stage renal disease. Because of this condition, the nurse monitors drug levels to assess for: Answers: 1. drug ineffectiveness
A nurse working in an obstetrics clinic is reviewing the pregnancy classification of drugs. The FDA developed a pregnancy classification regarding drug effects on an unborn child (fetus). The two drug categories that are considered safe to use during pregnancy are: Answers: 1. categories B and C
A nurse is soliciting a history from a woman of childbearing years and the client believes she may be pregnant. She is taking a medication that the nurse discovers is category X. The description for pregnancy category X is: Answers: 1. no risk to fetus
Which of the following statements by a client who is undergoing anti neoplastic therapy would be of concern to he nurse? (MARK ALL THAT APPLY) Answers: "I have attended a meeting of a cancer support group" "I am eating six small meals plus two protein shakes a day." "My husband and I are planning a short trip next week" "I am going to go shopping at the at the mall next week." "I am taking my 15-month old granddaughter to the pediatrician next week for her baby shots." Response Feedback: The nurse should be concerned for the following: Clients and family members should avoid receiving live virus vaccinations or exposure to chickenpox. The client could have an exacerbation or a more pronounced episode of the disease. The client should not care for the granddaughter if vaccination with live viruses is planned. The client should also avoid crowds, especially in enclosed spaces when possible, to minimize exposure risk. The nurse should discuss measures to minimize the risk of infections if the client
should expect thrombocytes to increase in 1 week should expect erythroctyes (reticulocytes) to increase after 1 week should drink Feresol with a straw report feeling dizzy during IV administration related to possible decease in B/P should avoid food intake regardless of GI upset
Patient's receiving cyanocobalamin: Mark all that apply. Answers: (^) should take K+ supplements should have a diet high in protein should drink oral medications with a straw should be aware folic acid supplements may mask cyanocobalamin deficiency should understand they have a lack of vitamin 12 should understand they have a lack of folic acid should understand they have a lack of iron
A patient receiving Zidoduvine should avoid: Mark all that apply. Answers: MMR vaccine furosemide (Lasix) erythropoietin methotrexate (Rheumtrex)
A client who is being treated with iron supplements is not exhibiting the increased amount in his blood that was anticipated. The nurse suspects that his diet or lifestyle may be inhibiting absorption of the iron. The nurse recognizes that the client’s absorption of iron intake may be hampered by consumption of: Answers: oral ascorbic acid and citrus fruits. antacids taken with meals other multivitamins, ingested concurrently. a full meal 2 hours after iron intake. Response Feedback: Antacids and food decrease the ability for iron to be absorbed by the gastric lining. Ascorbic acid enhances absorption.
A patient who is particular about her skin appearance is worried about the injection. She is about to receive an intramuscular injection of iron (Dextran), which site would be the best choice for the injection? Answers: dorsogluteal ventral gluteal deltoid vastus lateralis Response Feedback: Z-track method injection should be utilized to prevent leakage into the SQ skin. Iron (Dextran) given IM may stain the skin. Dorsogluteal injections are not recommended due to possibly injecting the sciatic nerve. Vastus lateralus should be utilized for children since this is the largest muscle. Deltoid injections are typical injections, but to assure staining is not visible the vental gluteal would be the best choice.
Mark all that apply with intrinsic factor: Answers: Folic Acid has decreased absorption with intrinsic factor. Cyanocobalamin cannot be absorbed without intrinsic factor. Cyanocobalamin has increased absorption with intrinsic factor. Ferrous sulfate has increased absorption with intrinsic factor. Cyanocobalamin has decreased absorption with intinsic factor.
A lack of which of the following may lead to a beefy, red tongue? Answers: Ferrous Sulfate Cyanocobalamin Folic Acid Intrinsic Factor
Which following medication is utilized for treatment of Herpes Simplex? Answers: Doxycycline Nitrofurantoin
A client is demonstrating signs and symptoms of anemia. Select the signs and symptoms of this condition: Mark all that apply. Answers: 1. decreased clotting
A client is discharged on anticancer medications. An advantage for home use of these medications is: Answers: 1. it can be closely monitored for potency of the drug
A client is ordered to receive chemotherapy. The nurse is aware that the tumors that respond best to anticancer drugs are those with: Answers:
A client is receiving chemotherapy and is experiencing nausea and vomiting. Select the following actions that would be effective in managing these side effects: Select all that apply
Answers:
A client is taking G-CSF, or filgrastim (Neupogen). Which of the following nursing interventions is indicated for the most common side effect of this medication? Answers: 1. stool softeners and a high-fiber diet for constipation
A client with cancer is on chemotherapy and neutropenic precautions. This is because clients taking anticancer drugs are susceptible to infections resulting from: Answers: 1. decreased platelet count
A client with cancer is being treated with medication via intravenous therapy. The client is noted to have swelling at the IV site, pain at the IV site, and cool and pale skin. This is of special concern if the drug is: Answers: 1. an antimetabolite
A client receiving interferon is experiencing rigors. Which of the following nursing interventions may be implemented to prevent and treat this condition? Answers: (^) 1. Pretreat the patient with acetaminophen and meperidine (Demerol).
A client receiving chemotherapy and biologic response modifiers is experiencing signs of bone marrow suppression, including neutropenia, anemia, and thrombocytopenia. Which of the following signs and symptoms indicate thrombocytopenia? Answers: 1. shortness of breath, pallor, and fatigue
A client questions a nurse about taking antiretrovirals with other medications, which may cause drug interactions. The nurse should make which of the following statements with regard to taking these medications? Answers: 1. “Next time you go to your doctor, let the doctor know all the medications you are taking.”
Response Feedback: The nurse needs to ensure that there are no drug-drug interactions before beginning aggressive therapy.
A client is to receive oprelvekin (Neumega). One of the chief side effects of this medication is fluid retention. Which of the following assessments would confirm this condition? Answers: 1. bradycardia and hypotension
hypothermia and ventricular dysrhythmias Response Feedback: These are signs of overhydration.
A client is to receive filgrastim (Neupogen) as a granulocyte-stimulating factor. This medication should not be given: Answers: 1. to clients with ANCs of less than 500
to a patient with a history of hypertension
to patients with severe myelosuppression
A patient with testicular cancer is ordered to receive etoposide (VePesid). It is noted that the patient’s BUN level is slightly elevated and his creatinine clearance time is slightly prolonged. The nurse would anticipate the dose of the medication would be: Answers: (^) 1. reduced
A client with leukemia is receiving colony-stimulating factors (CSFs). The nurse is aware that these medications: Answers: 1. treat bacterial infections
A client with lung cancer is being treated with chemotherapy. The nurse monitors the client’s CBC (complete blood count). The purpose of monitoring this value is to: Answers: 1. assess for circulatory function
Biologic response modifiers (BRMs) are a class of drugs used to: Answers: 1. decrease severity of infection
Enfuvirtide (Fuzeon) is a new antifusion inhibitor used in treating HIV. In teaching the client about this medication, the most common adverse reaction must be addressed. The nurse would instruct the patient to watch for: Answers:
Estrogen therapy is treatment for progressive prostatic cancer and breast cancer (postmenopausal women). The nurse administers the estrogen with the awareness that the proposed action of estrogen is to: Answers: 1. increase tumor growth
Use of antiretroviral therapy has been found effective in decreasing the vertical transmission of HIV. Initiation of zidovudine therapy to HIV-infected pregnant women is recommended at which of the following weeks of gestation? Answers:
Which of the following are side effects noted to occur with the administration of erythropoietin? Answers: 1. orthostatic hypotension and dizziness
(WBC) was 1,000 mm3. Based on this laboratory report, nursing care plan must include nursing interventions to Answers: 1. Prevent dehydration
Mrs. Balboa, a client with congestive heart failure, has a slightly elevated BUN. What is the most likely explanation for the abnormal BUN? Answers: 1. Plasma dilution caused by aldosterone increase
The nurse suspects that the client may be experiencing peripheral neuropathy as a result of receiving paclitaxel (Taxol). What is the highest priority nursing intervention to use in monitoring the client for this adverse reaction? Answers: a. Numbness and/or tingling of the fingers and toes b. Decrease in levels of white blood cells and platelets c. Increase in overactive deep tendon reflexes d. Paralysis of the muscles in the lower extremities Response Feedback: Symptoms of neuropathy include feelings of numbness and/or tingling in the fingers and toes.
A client is ordered to receive cyclophosphamide (Cytoxan). The client is advised to drink increased water and fluids to: Answers: a. increase the red blood cell count. b. prevent liver dysfunction. c. prevent renal failure.
d. prevent hemorrhagic cystitis. Response Feedback: Cytoxan can cause hemorrhagic cystitis and irritation of the bladder wall.
A male client is receiving chemotherapy and is concerned about endangering his female sexual partner while he is receiving the drugs. The nurse’s highest priority instruction to this client is to __________ receiving the drugs. Answers: a. continue to use his preferred method of birth control while b. abstain from sexual activity for 7 days after c. use condoms for up to seven days after d. use a second form of birth control while Response Feedback: Condoms should be used for up to 7 days after receiving the drugs to prevent endangering the client’s sexual partner.
A patient is ordered to receive an angiogenesis inhibitor called bevacizumab (Avastin). During a client teaching session, the nurse instructs the patient that the primary function of this medication is to: Answers: a. prevent blood vessel growth in cancer tumors. b. suppress inflammatory tumor growth. c. treat opportunistic infections. d. inhibit DNA replication in cancer cells. Response Feedback: The primary action of the medication is to prevent blood vessel growth in cancer tumors.