Pharmacology A Patient Centered Nursing Process Approach 8th Edition-Kee -Hayes -Test Bank

<< Nursing A Concept Based Approach to Learning Volume II 2nd Ed-Test Bank Pharmacology A Patient Centered Nursing Process Approach 9th Edition By Linda E-Test Bank >>
Product Code: 222
Availability: In Stock
Price: $24.99
Qty:     - OR -   Add to Wish List
Add to Compare

Pharmacology A Patient Centered Nursing Process Approach 8th Edition-Kee -Hayes -Test Bank

Description

WITH ANSWERS
Pharmacology A Patient Centered Nursing Process Approach 8th Edition-Kee -Hayes -Test Bank

Chapter 02: The Drug Approval Process

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse is preparing to administer a schedule II injectable drug and is drawing up half of the contents of a single-use vial. Which nursing action is correct?
a. Ask another nurse to observe and cosign wasting the remaining drug from the vial.
b. Keep the remaining amount in the patients drawer to give at the next dose.
c. Record the amount unused in the patients medication record.
d. Dispose of the vial with the remaining drug into a locked collection box.

 

 

ANS:  A

Schedule II drugs are controlled substances, and all must be accounted for. When wasting a portion of a drug, another nurse should observe and cosign that a drug was wasted.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 16

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient is prescribed a medication and asks the nurse if the drug is available in a generic form. The nurse understands that a generic medication will have a name that
a. is a registered trademark.
b. is always capitalized.
c. describes the drugs chemical structure.
d. is non-proprietary.

 

 

ANS:  D

The generic name is the official, non-proprietary name for a drug. The brand name is the trademark name and is always capitalized. The chemical name describes the chemical structure of the drug.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 18

TOP:   NURSING PROCESS: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient receives a prescription on which the provider has noted that a generic medication may be given. The patient asks the nurse what this means. What will the nurse tell the patient about generic drugs?
a. They contain the same inert ingredients as brand-name drugs.
b. They have chemical structures that are identical to proprietary drugs.
c. They tend to be less expensive than brand-name drugs.
d. They undergo extensive testing before they are marketed.

 

 

ANS:  C

Generic drugs are approved by the FDA if they are proved to be bioequivalent to the brand-name drug. They tend to be less expensive because manufacturers of these drugs do not have to do the extensive testing required of brand-name drugs before marketing. They are not identical to brand-name drugs and often have different inert ingredients.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 18

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Management of Client Care

 

  1. The nurse reviews information about a drug and notes the initials USP after the drugs official name. The nurse understands that this designation indicates the drug
a. is a controlled substance.
b. is approved by the U.S. Food and Drug Administration (FDA).
c. is available in generic form.
d. meets quality and safety standards.

 

 

ANS:  D

The USP designation is given to drugs that have met high standards for therapeutic use, patient safety, quality, purity, strength, packaging safety, and dosage form by the United States Pharmacopoeia National Formulary. The FDA classifies controlled substances with Roman numerals from I to V. The USP designation does not indicate FDA approval. The USP designation does not indicate generic availability.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 15

TOP:   NURSING PROCESS: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse is preparing to give a medication to a child. The childs parent asks whether the drug is safe for children. How will the nurse respond to the parent?
a. Drugs are tested on adults and safe doses for children are based on weights compared to adult weights.
b. Drugs are deemed safe for children over time when repeated use proves effectiveness and safety.
c. Drugs are tested for both efficacy and safety in children in order to be marketed for pediatric use.
d. Drugs are tested on children in postmarketing studies and on a limited basis.

 

 

ANS:  C

The Pediatric Research Equity Act requires drug manufacturers to test drugs on children.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 17

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Which law(s) govern all drug administration by nurses?
a. Drug Regulation and Reform Act
b. FDA Amendments Act
c. Nurse Practice Acts
d. The Controlled Substances Act

 

 

ANS:  C

Each states Nurse Practice Act identifies how nurses administer medications. The other acts govern how drugs are marketed and tested.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 17

TOP:   NURSING PROCESS: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse administers a drug and miscalculates the dose by placing the decimal place one space to the right, resulting in a 10-fold overdose and the death of the patient. What offense does this represent?
a. Malfeasance
b. Malpractice
c. Misfeasance
d. Nonfeasance

 

 

ANS:  C

Misfeasance is negligence in giving either the wrong drug or the wrong dose, resulting in the death of the patient.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 17

TOP:   NURSING PROCESS: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse is busy and neglects to give a drug to a patient resulting in the patients death. What offense does this represent?
a. Malfeasance
b. Malpractice
c. Misfeasance
d. Nonfeasance

 

 

ANS:  D

Nonfeasance is omitting a drug dose, resulting in the patients death.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 17

TOP:   NURSING PROCESS: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient is taking methadone as part of a heroin withdrawal program. The nurse understands that, in this instance, methadone is classified as which drug schedule?
a. C-I
b. C-II
c. C-III
d. C-V

 

 

ANS:  B

Methadone is a category II drug, with a high potential for drug abuse.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 16

TOP:   NURSING PROCESS: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse is preparing to administer a combination drug containing acetaminophen and codeine. The nurse knows that this drug is classified as which drug schedule?
a. C-II
b. C-III
c. C-IV
d. C-V

 

 

ANS:  B

Codeine is normally a category II drug, except when it is part of a combination product such as with acetaminophen, making it a category III drug.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 16

TOP:   NURSING PROCESS: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

MULTIPLE RESPONSE

 

  1. Which are responsibilities of the U.S. Food and Drug Administration (FDA)? (Select all that apply.)
a. To ensure a drug has accurate labeling
b. To ensure a drug is affordable
c. To ensure a drug is effective
d. To ensure a drug is free from adverse reactions
e. To ensure a drug is tested for harmful effects

 

 

ANS:  A, C, E

The FDA ensures that drugs are labeled correctly, that they are tested and proven effective for the conditions they are marketed to treat, and that they are tested for harmful effects. The FDA does not ensure affordability or freedom from adverse reactions, although these must be noted in drug information materials.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Pages 15-16

TOP:   NURSING PROCESS: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

Chapter 14: Medications and Calculations

Test Bank

 

OTHER

 

  1. Order: trihexyphenidyl hydrochloride (Artane) 6 mg, PO, twice daily

Available:

How many tablet(s) will the patient receive on a daily basis?

 

ANS:

6

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: allopurinol (Zyloprim) 150 mg, PO, q.i.d.

Available:

  1. How many tablet(s) will be given per dose?
  2. How many mg will the patient receive per day?

 

ANS:

  1. tablet
  2. 600 (150 4)

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: doxycycline hyclate (Vibra-Tabs) 100 mg, PO, first day q12h; then100 mg, PO, daily

Available:

  1. How many tablet(s) will the patient receive the first day?
  2. How many tablet(s) will the patient receive daily after the first day?

 

ANS:

  1. 2
  2. 1

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: Augmentin 500 mg, PO, q8h

Available:

How many tablet(s) will be given per dose?

 

ANS:

2

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: erythromycin 350 mg, PO, q8h.

Available: erythromycin estolate 250 mg/5 mL

How many mL will be given per dose?

 

ANS:

7

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: Mycostatin U 300,000, PO, q.i.d. (swish and swallow)

Available: Mycostatin 100,000 units per mL

How many mL will be given?

 

ANS:

3

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: Norvir 600 mg, PO, b.i.d.

Available:

 

  1. How many milliliters (mL) will the patient receive per dose?
  2. How many milligrams (mg) will the patient receive per day?

 

ANS:

  1. 7.5 or 7
  2. 1200

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: methenamine mandelate 500 mg, PO, q.i.d.

Available:

How many tablet(s) will be given per dose?

 

ANS:

1

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: cefadroxil (Duricef) 0.4 g, PO, q12h

Available:

How many mL will be given per dose?

 

ANS:

8

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: Serzone (nefazodone hydrochloride), PO: Day 1, 200 mg in two divided doses; Day 2, 100 mg in two divided doses; may increase to 100 mg, b.i.d.

Available:

 

  1. How many tablets will the patient receive on Day 1?
  2. How many tablets will the patient receive per dose when ordered 100 mg in 2 divided doses?
  3. How many tablets will the patient receive per dose when increased to 100 mg, b.i.d.?

 

ANS:

  1. 4
  2. 1
  3. 2

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: amoxicillin (Amoxil) 300 mg, PO, q8h

Available:

  1. How many mL will the patient receive per dose?
  2. How many mg will the patient receive per day?
  3. How many mL will the patient receive per day?

 

ANS:

  1. 7.5 or 7
  2. 900
  3. 22.5 or 22

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: Thorazine 10 mg, IM (deep), STAT

Available:

How many mL will be given?

 

ANS:

0.4

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Pages 180-183

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: Compazine 7.5 mg, IM (deep), q.i.d., PRN

Available:

How many mL will be given per dose?

 

ANS:

1.5 or 1

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Pages 180-183

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: loxapine (Loxitane) 75 mg, IM, daily

Available:

How many milliliters (mL) will the patient receive?

 

ANS:

1.5 or 1

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Pages 180-183

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: midazolam (Versed) 3 mg, IM, STAT

Available: Versed 10 mg/2 mL

How many mL will be given?

 

ANS:

0.6

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Pages 180-183

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: 1000 mL of lactated Ringers (LR) solution to be administered in 6 hours

Available: 1 L LR Macrodrip set labeled 10 gtt/mL

 

  1. How many mL of LR will be infused in 1 hour?
  2. How many drops per minute (gtt/min) will the patient receive?

 

ANS:

  1. 167 (1000 mL 6 = 166.6 = 167 mL)
  2. 28 ([167 10 gtt] 60 min = 27.8 or 28 gtt/min)

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Pages 190-191

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: aminocaproic acid 4 g in 250 mL D5W to infuse in 1 hour

Set: secondary set labeled 15 gtt/min

Available:

  1. How many mL of aminocaproic acid will be mixed in 250 mL of D5W?
  2. How many gtt/min will the patient receive?

 

ANS:

  1. 16
  2. 63

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Pages 190-191

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: cefuroxime axetil (Ceftin) 200 mg, PO, b.i.d.

Available: Ceftin 250 mg/5 mL

How many mL will the patient receive per dose?

 

ANS:

4

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: digoxin (Lanoxin), PO, 62.5 mcg, daily

Available: Lanoxin 0.125-mg tablets

How many mg will the patient receive per day?

 

ANS:

0.0625

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: trimethoprim-sulfamethoxazole (Bactrim) 160/800 mg, PO, b.i.d.

Available: Bactrim 80/400-mg tablets

How many tablets will be given per dose?

 

ANS:

2

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: amoxicillin (Amoxil) 300 mg, PO, b.i.d.

Available: Amoxil 400 mg/5 mL

How many mL will be given per dose?

 

ANS:

3.75

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: levetiracetam (Keppra), PO, 20 mg/kg/day, divided b.i.d.

Available: Keppra 100 mg/mL

Patient weight: 20 kg

How many mL will the patient receive per dose?

 

ANS:

2

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 167

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

Chapter 28: Antidepressants and Mood Stabilizers

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse performs a medication history on a newly admitted patient. The patient reports taking amitriptyline (Elavil) 75 mg at bedtime for 6 weeks to treat depression. The patient reports having continued fatigue, lack of energy, and depressed mood. The nurse will contact the provider to discuss which intervention?
a. Beginning to taper the amitriptyline
b. Changing to a morning dose schedule
c. Giving the amitriptyline twice daily
d. Increasing the dose of amitriptyline

 

 

ANS:  A

The response to tricyclic antidepressants (TCAs) should occur after 2 to 4 weeks of therapy. If there is no improvement at this time, the TCA should be gradually withdrawn and an SSRI prescribed. TCAs should never be stopped abruptly. TCAs cause fatigue and drowsiness, so they should be given at bedtime. Changing the dose or the dosing schedule are not indicated.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 387

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse is teaching a patient who will begin taking doxepin (Sinequan) to treat depression. Which statement by the patient indicates a need for further teaching?
a. I should expect results within 2 to 4 weeks.
b. I should increase fluids and fiber while taking this medication.
c. I should take care when rising from a sitting to standing position.
d. I will take the medication in the morning before breakfast.

 

 

ANS:  D

Tricyclic antidepressants (TCAs) should begin to show effects within 1 to 4 weeks. Tricyclic antidepressants are known to cause orthostatic hypotension and constipation, so patients should be counseled on how to minimize these effects. TCAs should be taken at bedtime because of their tendency to cause drowsiness.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 392

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who is taking amitriptyline (Elavil) reports constipation and dry mouth. The nurse will give the patient which instruction?
a. Increase fluid intake.
b. Notify the provider.
c. Request another antidepressant.
d. Stop taking the medication immediately.

 

 

ANS:  A

Constipation and dry mouth are common side effects of tricyclic antidepressants (TCAs), and patients should be taught to manage these symptoms. There is no need to notify the provider or to switch medications unless the side effects become too uncomfortable. Patients should not stop taking TCAs abruptly.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 397

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has had a loss of interest in most activities, weight loss, and insomnia is diagnosed with a major depressive disorder and will begin taking fluoxetine (Prozac) daily. The patient asks about the weekly dosing that a family member follows. What will the nurse tell the patient about a weekly dosing regimen?
a. It can be used after daily maintenance dosing proves effective and safe.
b. It is used after a trial of tricyclic antidepressant medication fails.
c. It is not effective for this type of depression and its symptoms.
d. It will cause more adverse effects than daily dosing regimens.

 

 

ANS:  A

Before weekly dosing is begun, the patient should respond to a daily maintenance dose of 20 mg/day without serious effects. It is not necessary to undergo a trial of tricyclic antidepressants (TCAs). Weekly dosing is used for this type of depression, and although it may have some adverse effects, these are not more common than with daily dosing.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 388

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient has been taking sertraline (Zoloft) 20 mg/mL oral concentrate, 1 mL daily for several weeks and reports being unable to sleep well. What will the nurse do next?
a. Ask the patient what time of day the medication is taken.
b. Counsel the patient to take the medication at bedtime.
c. Recommend asking the provider about weekly dosing.
d. Suggest that the patient request a lower dose.

 

 

ANS:  A

Selective serotonin reuptake inhibitors (SSRIs) cause nervousness and insomnia. Patients can minimize these effects by taking the drug in the morning. The nurse should assess this with this patient. Taking the medication at bedtime will only increase the insomnia. Requesting a lower dose or changing to weekly dosing are not recommended.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 392

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient has been taking paroxetine (Paxil) 20 mg per day for 2 weeks and reports headaches, nervousness, and poor appetite. Which action will the nurse take?
a. Counsel the patient to take the medication with food.
b. Reassure the patient that these side effects will decrease over time.
c. Suggest that the patient discuss a lower dose with the provider.
d. Tell the patient to stop taking the drug and contact the provider.

 

 

ANS:  B

These are common side effects of SSRIs and will subside over time. Taking the medication with food will not affect these side effects. Lowering the dose is not indicated. Patients should not abruptly stop taking SSRIs.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 388

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has been diagnosed with social anxiety disorder will begin taking venlafaxine (Effexor). The nurse who performs a medication and dietary history will be concerned about ingestion of which substance or drug?
a. Coffee
b. Grapefruit juice
c. Oral hypoglycemic drug
d. St. Johns wort

 

 

ANS:  D

The concurrent interaction of venlafaxine and St. Johns wort may increase the risk of serotonin syndrome and neuroleptic malignant syndrome. Oral hypoglycemic drugs are concerning for patients who take lithium. Coffee and grapefruit juice is to be avoided by patients who take monoamine oxidase inhibitors

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 388

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A male patient has been taking venlafaxine (Effexor) 37.5 mg daily for 2 weeks and reports ejaculation dysfunction and urinary retention. What action will the nurse take?
a. Contact the provider to discuss decreasing the dose.
b. Reassure the patient that these are common side effects.
c. Report potential serious adverse effects to the provider.
d. Withhold the dose until the provider is notified.

 

 

ANS:  B

Venlafaxine can cause ejaculation dysfunction and urinary retention, and these side effects tend to be transient and treatable. Decreasing the dose is not indicated, and these are not serious adverse effects. Withholding the dose is not indicated.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 389

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has been taking a monoamine oxidase (MAO) inhibitor for several months will begin taking amoxapine (Asendin) instead of the MAO inhibitor. The nurse will counsel the patient to begin taking the amoxapine
a. along with the MAO inhibitor for several months.
b. at least 14 days after discontinuing the MAO inhibitor.
c. the day after the last dose of the MAO inhibitor.
d. while withdrawing the MAO inhibitor over several weeks.

 

 

ANS:  B

Amoxapine is an atypical antidepressant that should not be taken with MAO inhibitors and should not be used within 14 days of taking an MAO inhibitor.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 389

TOP:   NURSING PROCESS: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has been diagnosed with depression asks why the provider has not ordered a monoamine oxidase (MAO) inhibitor to treat the disorder. The nurse will explain to the patient that MAO inhibitors
a. are more expensive than other antidepressants.
b. are no longer approved for treating depression.
c. can cause profound hypotension.
d. require strict dietary restrictions.

 

 

ANS:  D

MAO inhibitors have many food and drug interactions that can be fatal, and patients must adhere to strict dietary restrictions while taking these drugs. They are not more expensive than the newer antidepressants. They remain approved for treating depression. MAO inhibitors cause profound hypertension.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 389

TOP:   NURSING PROCESS: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who takes a monoamine oxidase (MAO) inhibitor asks the nurse about taking over-the-counter medications to treat cold symptoms. Which medication will the nurse counsel the patient to avoid while taking an MAO inhibitor?
a. Diphenhydramine
b. Guaifenesin
c. Pseudoephedrine
d. Saline nasal spray

 

 

ANS:  C

MAO inhibitors can cause hypertensive crises, which can be fatal when taken with sympathomimetic drugs such as pseudoephedrine.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 391

TOP:   NURSING PROCESS: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has a major depressive disorder has been taking fluoxetine (Prozac) 20 mg daily for 3 months and reports improved mood, less fatigue, and an increased ability to concentrate. The patients side effects have diminished. What will the nurse counsel this patient to discuss with the provider?
a. Changing to once-weekly dosing
b. Decreasing the dose to 10 mg daily
c. Discontinuing the medication
d. Increasing the dose to 30 mg daily

 

 

ANS:  A

Once patients have demonstrated control of symptoms with decreased side effects on the maintenance dose of 20 mg daily, patients may begin once-weekly dosing. The 20-mg dose is maintenance dosing, so decreasing or increasing the dose is not indicated. Patients should not stop taking the medication abruptly.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 388

TOP:   NURSING PROCESS: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has been diagnosed with a major depression disorder has been ordered to take doxepin (Sinequan). The nurse will contact the provider if the patients medical history reveals a history of which condition?
a. Asthma
b. Glaucoma
c. Hypertension
d. Hypoglycemia

 

 

ANS:  B

Antidepressants, such as doxepin, that cause anticholinergic-like symptoms are contraindicated if the patient has glaucoma.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 394

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse is preparing to administer a dose of lithium (Lithibid) to a patient who has been taking the drug as maintenance therapy to treat bipolar disorder. The nurse assesses the patient and notes tremors and confusion. The patients latest serum lithium level was 2 mEq/L. Which action will the nurse take?
a. Administer the dose.
b. Hold the dose and notify the provider.
c. Request an order for a higher dose.
d. Request an order for a lower dose.

 

 

ANS:  B

The patient has symptoms of lithium toxicity, and the serum drug level is in toxic range. The nurse should hold the dose and notify the provider.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 396

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse assesses a patient who is taking lithium (Lithibid) and notes a large output of clear, dilute urine. The nurse suspects which cause for this finding?
a. Cardiovascular complications
b. Expected lithium side effects
c. Increased mania
d. Lithium toxicity

 

 

ANS:  D

An increased output of dilute urine is a sign of lithium toxicity.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 397

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse provides teaching for a patient who will begin taking lithium (Lithibid). Which statement by the patient indicates understanding of the teaching?
a. I may drink tea or cola but not coffee.
b. I may stop taking the drug when mania symptoms subside.
c. I should consume a sodium-restricted diet.
d. I should drink 2 to 3 liters of fluid each day.

 

 

ANS:  D

Patients taking lithium should be encouraged to maintain adequate fluid intake of 2 to 3 L/day initially and then 1 to 2 L/day as maintenance. Patients should not drink any caffeine-containing drinks, including tea and cola. Patients must continue taking lithium even when symptoms subside, or else symptoms will recur. It is not necessary to consume a sodium-restricted diet.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 397

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has recently begun taking lithium (Lithibid) calls the clinic to report nausea, vomiting, anorexia, and drowsiness. What will the nurse do next?
a. Contact the provider to obtain an order for a serum lithium level.
b. Reassure the patient that these symptoms are common and transient.
c. Tell the patient that the lithium dose is probably too low.
d. Tell the patient to stop taking the medication immediately.

 

 

ANS:  A

Early symptoms of lithium toxicity include nausea and vomiting, anorexia, and drowsiness. The nurse should obtain an order for a lithium level to evaluate this. Patients should be encouraged to report these symptoms if they occur. Patients should never be counseled to stop the medication abruptly.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 397

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse is preparing to administer paroxetine HCl (Paxil) to a 70-year-old patient. The nurse understands that this patient may require
a. a decreased dose.
b. an increased dose.
c. every other day dosing.
d. more frequent dosing.

 

 

ANS:  A

Older adults usually need a lower dose of antidepressants.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 392

TOP:   NURSING PROCESS: Assessment/Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has a history of migraine headaches is diagnosed with bipolar disorder. The nurse might expect the provider to order which medication for this patient?
a. Carbamazapine (Tegretol)
b. Divalproex (Valproate)
c. Lamotrigine (Lamictal)
d. Lithium citrate (Eskalith)

 

 

ANS:  B

All of these medications may be used to treat bipolar disorder, but divalproex is also indicated for migraine prophylaxis.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 394

TOP:   NURSING PROCESS: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

MULTIPLE RESPONSE

 

  1. The nurse is teaching a patient about foods to avoid when taking isocarboxazid (Marplan). Which foods will the nurse instruct the patient to avoid? (Select all that apply.)
a. Bananas
b. Bread
c. Eggs
d. Red wine
e. Sausage
f. Yogurt

 

 

ANS:  A, D, E, F

Aged cheeses and wines are the chief foods that are prohibited. Any food containing tyramine, which has sympathomimetic effects, can cause a hypertensive crisis. This includes bananas, sausage, and yogurt.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 393

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

Chapter 42: Cardiac Glycosides, Antianginals, and Antidysrhythmics

Test Bank

 

MULTIPLE CHOICE

 

  1. A patient who has atrial fibrillation is taking digoxin. The nurse expects which medication to be given concurrently to treat this condition?
a. Hydrochlorothiazide (HydroDIURIL)
b. Inamrinone (Inocor)
c. Milrinone (Primacore)
d. Warfarin (Coumadin)

 

 

ANS:  D

Digoxin is given for atrial fibrillation to restore a normal heart rhythm. To prevent thromboemboli, warfarin is given concurrently. Hydrochlorothiazide is a diuretic medication. Inamrinone and milrinone are inotropic agents that would be used instead of digoxin.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 603

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient is diagnosed with heart failure, and the prescriber has ordered digoxin. The patient asks what lifestyle changes will help in the management of this condition. The nurse will recommend which changes?
a. Aerobic exercise and weight lifting 2 or 3 times weekly
b. Changing from cigarette smoking to pipe smoking
c. Consuming 2 teaspoons or less of salt every day
d. Having no more than one alcoholic beverage per day

 

 

ANS:  D

Alcohol should either be completely avoided or restricted to no more than one per day. Mild exercise, such as walking, is recommended. All nicotine deprives the heart of oxygen. Salt should be limited to no more than one teaspoon per day.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 603

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient with chronic obstructive pulmonary disease (COPD) has increasing dyspnea and is being evaluated for heart failure (HF). Which test will be ordered to help differentiate between dyspnea due to lung dysfunction and dyspnea due to HF?
a. Atrial natriuretic hormone (ANH) level
b. Brain natriuretic peptide (BNP) level
c. Cardiac enzymes
d. Electrocardiogram (ECG)

 

 

ANS:  B

The BNP is used to differentiate that dyspnea is due to HF and not lung dysfunction. The other tests will all be a part of the diagnostic workup but do not help with this distinction.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 603

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pathophysiology

 

  1. The nurse is preparing to administer digoxin to a patient who has heart failure. The patient reports nausea, vomiting, and a headache. The nurse notes a respiratory rate of 18 breaths per minute, a heart rate of 58 beats per minute, and a blood pressure of 120/78 mm Hg. What will the nurse do next?
a. Administer the next dose as ordered since these are mild side effects.
b. Hold the dose and notify the provider of possible digoxin toxicity.
c. Reassure the patient that these are common, self-limiting side effects.
d. Request an order for an antiemetic and an analgesic medication.

 

 

ANS:  B

Nausea, vomiting, and headache are common signs of digoxin toxicity as is a heart rate less than 60 beats per minute. The nurse should hold the dose and notify the provider.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 603

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse is caring for a patient who is taking digoxin to treat heart failure. The patients electrocardiogram shows a ventricular dysrhythmia. The nurse will notify the provider and will anticipate an order for which medication?
a. Digoxin immune Fab (Digibind)
b. Furosemide (Lasix)
c. Phenytoin (Dilantin)
d. Potassium

 

 

ANS:  C

The antidysrhythmics phenytoin and lidocaine are effective in treating digoxin-induced ventricular dysrhythmias. Digoxin immune Fab is used to treat severe digitalis toxicity, characterized by bradycardia, nausea, and vomiting. Unless a potassium deficit is present, giving potassium could worsen the dysrhythmia.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 603

TOP:   NURSING PROCESS: Planning/Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who takes digoxin to treat heart failure will begin taking a vasodilator. The patient asks the nurse why this new drug has been ordered. The nurse will explain that the vasodilator is used to
a. decrease ventricular stretching.
b. improve renal perfusion.
c. increase cardiac output.
d. promote peripheral fluid loss.

 

 

ANS:  A

Vasodilators are given to decrease venous blood return to the heart, resulting in decreased cardiac filling and decreased ventricular stretching, in turn reducing preload, contractility, and oxygen demand on the heart.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 605

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse performs a medication history and learns that the patient takes a thiazide diuretic and digoxin (Lanoxin). The nurse will question the patient to ensure that the patient is also taking which medication?
a. Cortisone
b. Lidocaine
c. Nitroglycerin
d. Potassium

 

 

ANS:  D

If a patient is taking digoxin and a potassium-wasting diuretic such as thiazide, the patient should also take a potassium supplement to prevent hypokalemia that could result in digoxin toxicity. It is not necessary to take cortisone, lidocaine, or nitroglycerin unless the patient has symptoms that warrant these drugs.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 605

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. The nurse administers a dose of digoxin (Lanoxin) to a patient who has heart failure and returns to the room later to reassess the patient. Which finding indicates that the medication is effective?
a. Decreased dyspnea
b. Decreased urine output
c. Increased blood pressure
d. Increased heart rate

 

 

ANS:  A

The patient should show improvement in breathing and oxygenation. Urine output should increase. Blood pressure and heart rate will decrease.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 607

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has heart failure receives digoxin (Lanoxin) and an angiotension-converting enzyme (ACE) inhibitor. The patient will begin taking spironolactone (Aldactone). The patient asks why the new drug is necessary. The nurse will tell the patient that spironolactone will be given for which reason?
a. To enhance potassium excretion
b. To increase cardiac contractility
c. To minimize fluid losses
d. To provide cardioprotective effects

 

 

ANS:  D

Spironolactone is a potassium-sparing diuretic that blocks production of aldosterone, causing improved heart rate variability and decreased myocardial fibrosis. It is given in congestive heart failure for its cardioprotective effects. Spironolactone does not directly alter cardiac contractility but may slightly decrease contractility if fluid volume is decreased. It is a mild diuretic but is not given in this instance to minimize fluid losses.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension) REF:   Page 606

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. A patient who has stable angina pectoris is given nitroglycerin to use as needed. In addition to pharmacotherapy, the nurse will give the patient which instruction?
a. Avoid extremes in weather.
b. Begin a rigorous exercise program.
c. Drink glass of red wine daily.
d. Seek medical care at first sign of pain.

 

 

ANS:  A

Avoiding extreme weather conditions is important to help prevent anginal attacks. Patients should be instructed to avoid strenuous exercise; avoid alcohol, which can enhance hypotensive effects of nitrates; and use nitroglycerin at the first sign of pain.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                REF:   Page 607

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC

Write a review

Your Name:


Your Review: Note: HTML is not translated!

Rating: Bad           Good

Enter the code in the box below:



 

Once the order is placed, the order will be delivered to your email less than 24 hours, mostly within 4 hours. 

If you have questions, you can contact us here