Pharmacology Clear And Simple A Guide to Drug 2nd Edition By Watkins Test Bank

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Pharmacology Clear And Simple A Guide to Drug 2nd Edition By Watkins Test Bank

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WITH ANSWERS

Pharmacology Clear And Simple A Guide to Drug 2nd Edition By Watkins Test Bank

Chapter 2. Basics of Pharmacology

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   The nurse is preparing to apply valacyclovir (Valtrex) ointment to the shingles lesions located across a clients left side and lower back. Which of the following actions should the nurse take first?

A. Place the patient in a supine position.
B. Determine when the rash was first noted.
C. Ensure that the skin is clean and dry.
D. Take the patients vital signs.

 

 

____    2.   The nurse is providing care for a client at 32 weeks gestation who started low-molecular heparin injections after developing a deep vein thrombosis. The client asks the nurse, Why do I have to take a shot? Why cant I take the blood clot medicine that my dad takes orally? Which of the following responses by the nurse is best?

A. Anything that is fat-soluble, including warfarin (Coumadin), is able to cross the placental barrier. Heparin is not fat-soluble so it doesnt cross the barrier well.
B. The placenta is easily crossed by anything you take by mouth while you are pregnant, but not by things absorbed in other ways.
C. Only water-soluble substances such as vitamins can cross the placental barrier, so you could take either medication, but heparin is cheaper.
D. They are the same medication, but the shot is absorbed faster than the pill so the doctor wants you to take daily shots.

 

 

____    3.   The nurse is providing care to a client with HIV who has been prescribed fosamprenavir (Lexiva). Which of the following statements by the client indicates that further teaching is necessary?

A. The metabolites of this medication may be excreted in active form.
B. Im glad my kidneys work so well; otherwise the medication wouldnt work.
C. This drug actually has to be broken down by my body to fight the virus.
D. Isnt it fascinating that my liver has to metabolize the drug for it to work?

 

 

____    4.   The nurse is working with a client who was recently started on insulin therapy. The clients young daughter asks, Why do you have to give her a shot? Why cant you just give her a pill? Which of the following responses by the nurse is best?

A. Our bodies make insulin normally, so it is a liquid medication.
B. We do have diabetic medications in pill form. Im not sure why the doctor ordered it this way for your mom.
C. Insulin is manufactured and given this way so it absorbs more rapidly into the body.
D. The acid in your mothers stomach would destroy this medication, so it cant be swallowed.

 

 

____    5.   The nurse is providing care for a 48-year-old male on the surgical unit. Gentamicin (Garamycin) 2 mg/kg every 8 hours has been started. The nurse would be most concerned by which of the following findings?

A. Blood levels have been ordered every 24 hours
B. The patients EGFR = 40 mL/min
C. The patients hemoglobin = 11.8 g/dL
D. The patients WBC = 14,000 c/mm3

 

 

____    6.   A 16-year-old client comes to the urgent care clinic with symptoms of tonsillitis. The client tells the nurse she takes tetracycline (Doxycycline) daily for the treatment of acne. The nurse would be most concerned if the health care provider prescribed which of the following?

A. Amoxicillin clavulanate (Augmentin)
B. Cefdinir (Omnicef)
C. Cefixime (Suprax)
D. Ciprofloxacin (Cipro)

 

 

____    7.   The nurse is providing care for a client experiencing muscle spasms. The physician has ordered cyclobenzaprine (Flexeril). The nurse would inform the client to anticipate which of the following side effects?

A. Hypocalcemia and hypotension
B. Dizziness and drowsiness
C. Nausea and headache
D. Flaccidity and urinary retention

 

 

____    8.   While caring for clients on the medical unit, the nurse would see which of the following clients first?

A. A 28-year-old patient with HIV who has a temperature of 99.2F
B. A 54-year-old patient with diverticulitis whose diet was just advanced to solid food
C. A 61-year-old patient who takes ibuprofen for arthritis complaining of severe stomach pain
D. A 37-year-old patient with a kidney stone who is due for pain medication in 20 minutes

 

 

____    9.   While preparing to provide a patient admitted to the hospital for a laparoscopic hysterectomy the prescribed dose of ibuprofen (Motrin) 800 mg orally, which of the following actions would take highest priority?

A. Determine if the client has eaten within the past hour.
B. Assess the clients vaginal discharge.
C. Help the client ambulate in the hall.
D. Evaluate the clients most recent renal panel labs.

 

 

____  10.   The nurse is providing care for clients on the orthopedic unit. Which of the following assessment findings is most concerning to the nurse?

A. A client who takes lisinopril (Zestril) and is complaining of limited range of motion after shoulder surgery
B. A client with a fractured pelvis who takes warfarin sodium (Coumadin) and reports having a black tarry stool during the night
C. A client 2 days post-op for knee replacement who takes hydrocodone/acetaminophen (Vicodin) and refused to have labs drawn this morning
D. A client 4 days after hip replacement surgery taking omeprazole (Prilosec) who ordered spinach for dinner

 

 

____  11.   While working in the neonatal intensive care unit, the nurse notes an infants oxygen saturation has been 98% for the past 4 hours. The infant has been receiving oxygen at 4 L. Which of the following actions by the nurse is best?

A. Turn the oxygen level down to 3 L and monitor closely to reduce the risk of eye damage.
B. Leave the oxygen level at its current rate to reduce the risk of lung damage.
C. Turn the oxygen level down to 2 L and monitor closely to evaluate the infants readiness for transfer out of the ICU.
D. Leave the oxygen level at its current rate and inform the parents the baby will need supplemental oxygen at home.

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____    1.   While providing oral medications, the nurse recognizes which of the following is true regarding the absorption rate of a medication? (Select all that apply.)

A. The drugs level of fat solubility should be high to ensure absorption.
B. A medication will be more readily absorbed if it has a high pH.
C. A drug will be more readily absorbed if it is acidic in nature.
D. Absorption will be more rapid if it is provided in liquid form.
E. Absorption is slower in the presence of food.
F. A lozenge should be chewed to release the maximum amount of medication.

 

 

____    2.   While caring for multiple clients on the medical/surgical unit, the nurse would monitor which of the following individuals for potential liver toxicity? (Select all that apply.)

A. A 14-year-old patient taking atomoxetine (Strattera) who has a history of ADHD
B. A 44-year-old patient admitted for pneumonia who has been taking acetaminophen

(Tylenol)

C. A 63-year-old patient with a history of atrial fibrillation who has an irregular apical

pulse

D. A 19-year-old patient with a history of alcohol abuse admitted for a tonsillectomy
E. A 71-year-old patient with a history of tuberculosis who took isoniazid (Laniazid)
F. A 15-year-old patient who took multiple aspirin as part of a suicide attempt

 

 

____    3.   While working in the gastrointestinal diagnostic clinic, the nurse identifies which of the following individuals as at high risk for developing a gastric ulcer? (Select all that apply.)

A. A 41-year-old patient with a family history of Crohns disease
B. A 54-year-old patient who reports smoking 1.5 packs of cigarettes/day for the past 40 years
C. A 29-year-old patient taking misoprostol (Cytotec)
D. A 16-year-old patient with a 6-month history of bulimia
E. A 44-year-old patient who reports taking ibuprofen (Advil) daily for low back pain

 

 

____    4.   While providing medications to clients in the long-term care facility, which of the following actions would the nurse use to prevent gastrointestinal side effects? (Select all that apply.)

A. Give clients yogurt to prevent diarrhea.
B. Increase client intake of fiber to reduce gastric motility.
C. Provide milk or food with some medications to reduce the occurrence of nausea.
D. Improve absorption of the medication by giving it at night with a large snack.
E. Prevent constipation by providing fiber laxatives.

 

Chapter 2. Basics of Pharmacology

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Medication Provision; antivirals

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Absorption (p. 15). When administering an ointment for a rash, make sure the skin is clean and dry.

 

  1. ANS:  A                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Anticoagulant therapy          KEY:  Analysis

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Distribution (p. 16): The blood-placental barrier helps to filter drugs and other substances passing from mother to fetus. Most lipid-soluble drugs readily cross this barrier but water-soluble drugs do not. Warfarin (Coumadin) is fat-soluble and crosses the placental barrier while heparin does not. They are not the same medication and cost is not part of the therapeutic decision.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Medication Administration; antivirals

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Metabolism (p. 16): The liver does most of the work of drug metabolism. In some instances, a drug is administered in its inactive form to become activated through metabolism. This category of drugs is known as prodrugs. An example of a prodrug is fosamprenavir (Lexiva).

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Antidiabetics                        KEY:  Analysis

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Metabolism (p. 16): Insulin given by mouth is virtually useless; stomach acid breaks down insulin to an inactive form before it can be absorbed into the bloodstream. Oral diabetic medications are not forms of insulin; they stimulate the pancreas to release insulin.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Antibiotics                            KEY:  Analysis

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Issues Affecting the Drug Cycle (p. 17): Gentamicin is known to be both nephrotoxic (toxic to the kidneys) and ototoxic (toxic to the ears). Thus, kidney function and hearing would be monitored closely. The EGFR is the best measurement of kidney function. Normal value is >60 mL/min. While the clients hemoglobin is low, the kidney function is more concerning. An elevated WBC count is expected in the presence of an infection, which is the reason antibiotic therapy is provided. Routine blood levels to monitor drug dosage is expected to help prevent toxicity.

 

  1. ANS:  A                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Antibiotics                            KEY:  Application

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Issues Affecting Drug Cycle (p. 18): Antagonist drugs do the opposite by rendering another drug less powerful. The antibiotic tetracycline becomes ineffective when it is taken with penicillin. Amoxicillin clavulanate is a penicillin derivative.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Muscle relaxants                   KEY:  Application

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See The Importance of Side Effects (p. 18): Muscle relaxants such as Flexeril cause dizziness and drowsiness in addition to their intended actions.

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Anti-inflammatory agents     KEY:  Analysis

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Side Effects (p. 19): Clients who take nonsteroidal anti-inflammatory medications on a long-term basis run the risk of developing ulcers. This client is the most unstable and should be seen first.

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Anti-inflammatory agents     KEY:  Analysis

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Side Effects (p. 19): If kidney damage or impairment is suspected, BUN levels may be monitored to evaluate kidney function. Clients taking anti-inflammatory agents are at increased risk of kidney damage because these drugs are primarily metabolized through the kidneys instead of the liver.

 

  1. ANS:  B                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Anticoagulants                                KEY:   Analysis

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Side Effects (p. 19): Any patient taking an anticoagulant such as Coumadin to decrease clotting should be carefully monitored for signs of bleeding, including dark tarry stools. Coumadin levels should be monitored to ensure the drug level is therapeutic but not toxic.

 

  1. ANS:  A                    PTS:   1                    DIF:    Moderate        TOP:   Therapeutic Classification: NA

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Side Effects (p. 19): A serious problem is the use of oxygen in premature infants. At high doses, oxygen is very damaging to the eyes. For this reason, oxygen is now used at the lowest therapeutic dose possible for all age groups. This oxygen saturation level is very good, has been stable for 4 hours, and thus a trial on lower concentrations is warranted. Transfer out of ICU will depend on additional factors. Long-term use of oxygen cant be determined at this time.

 

MULTIPLE RESPONSE

 

  1. ANS:  A, C, D, E      PTS:   1                    DIF:    Hard               TOP:   Therapeutic Classification: NA

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Absorption (p. 15): The more soluble a medication is in fat or lipids, the more easily it is absorbed through the stomach. Medications with a low (acidic) pH are easily absorbed in the stomach. Liquid medications act faster than pills. A large amount of food slows absorption. If a patient sucks on a lozenge, more medication is released in the mouth than if the lozenge is chewed or swallowed.

 

  1. ANS:  B, D, E, F       PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Medication Administration   KEY:  Analysis

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Side Effects (p. 18): Alcohol, acetaminophen, isoniazid, and aspirin can cause liver damage.

 

  1. ANS:  B, E                PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Anti-inflammatory agents     KEY:  Analysis

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Side Effects (p. 19): The synthetic prostaglandin misoprostol (Cytotec) may be given to prevent the development of ulcers. Clients taking anti-inflammatory agents such as ibuprofen are at increased risk for ulcer formation. These patients are also urged to stop smoking to reduce the risk of ulcers.

 

  1. ANS:  A, C, E           PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Medication Administration   KEY:  Analysis

MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Side Effects (p. 19): Side effects are managed on an individual basis. Some medications require ingestion with milk or food. For certain drugs, adding yogurt to the diet is suggested to prevent diarrhea, and other drugs may require the addition of a high-fiber laxative to the diet to prevent constipation. Fiber will increase GI motility. The presence of food slows absorption rates.

 

 

Chapter 20. Reproductive and Urinary System Medications

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   The LPN is talking to her sister about various birth control methods. Her sister says, Bill and I just got married and we dont want to start a family for quite a while. Isnt there something that works long term but isnt permanent? Which of the following methods of birth control would the nurse suggest?

A. Ethinyl estradiol and etonogestrel (NuvaRing)
B. Nonoxynol-9 containing spermicide (Encare)
C. Transdermal patches (Ortho Evra)
D. Levonorgestrel intrauterine device (Mirena)

 

 

____    2.   The LPN is assisting in the care of a client who wants to discuss hormone replacement therapy (HRT) for menopause. The client states, My mother died of breast cancer, so I want to avoid anything that increases my chances of getting that. The nurse would base a response on which of the following principles?

A. There is no link between HRT and breast cancer.
B. HRT increases the risk of breast cancer development.
C. HRT decreases the risk of breast cancer development.
D. Studies involving HRT and breast cancer development have not been done.

 

 

____    3.   A woman at 42 weeks gestation is in for an appointment with the gynecologist. The woman reports inconsistent contractions on and off for three days and it is determined the cervix is not dilated at this time. The doctor informs the woman that they would like to provide dinoprostone (Prepidil). The nurse would help the woman understand this medication by stating which of the following?

A. It is given in IV form and is designed to stimulate labor within a few minutes.
B. It is a gel placed on the cervix to help soften it and should allow labor to start in 6 hours or less.
C. It is a cream inserted into the vagina to help prevent cervical dilation and postpone delivery.
D. It is an intramuscular injection given to help reduce muscle tension and stop contractions.

 

 

____    4.   An LPN working at an obstetricians office is talking to a woman who says, I just hope I dont have to have any pitocin. My sister had that when she was in labor and she said it was awful. The nurses response would be based on which of the following principles?

A. If pitocin is used during delivery there is increased risk of uterine cancer later in life.
B. Pitocin is given in the physicians office to initiate labor.
C. Women who use pitocin are being prepared for a cesarean section.
D. Pitocin is a synthetic oxytocin used to encourage uterine contractions.

 

 

____    5.   The LPN is working in an ob/gyn office and determines which of the following individuals is most likely to be taking terbutaline (Brethine)?

A. A 28-year-old patient with symptoms of pre-eclampsia
B. A 31-year-old patient with preterm labor
C. A 38-year-old patient at 39 weeks gestation who is experiencing regular contractions
D. A 19-year-old patient who has decided to terminate a possible pregnancy after unprotected sex 1 week ago

 

 

____    6.   An LPN working in a fertility clinic notes that teaching has been effective if the client taking menotropin (Humegon) states which of the following?

A. I will swallow this pill every day to help start the ovulation process.
B. My husband can learn to give me the shots so an egg will ripen and be released.
C. There are no risks associated with fertility medications.
D. My husband will need to get the same shots to help increase our chances of becoming pregnant.

 

 

____    7.   An LPN working at a community health fair recognizes which of the following individuals is at highest risk for erectile dysfunction?

A. A 44-year-old man with a history of inguinal hernia
B. A 50-year-old man with a history of asthma
C. A 48-year-old man with a history of diabetes
D. A 52-year-old man with a history of cholecystitis

 

 

____    8.   The LPN who works in a urology clinic would be most concerned if sildenafil (Viagra) were prescribed for which of the following individuals?

A. A 52-year-old patient with a history of hypertension
B. A 65-year-old patient with a history of migraine headaches
C. A 69-year-old patient with a history of benign prostatic hypertrophy
D. A 74-year-old patient with a history of gastroesophageal reflux disease

 

 

____    9.   An LPN is talking to a friend who states, My husband is visiting the doctor today to talk about getting a prescription for tadalifil (Cialis). He saw it on a commercial and thinks it may help. What do you know about that medication? Which of the following responses by the nurse is best?

A. Men take it half an hour to an hour before sexual activity to help attain and maintain an erection.
B. I know you can only safely take it once a week or less.
C. Its placed inside the urethral shaft to stimulate erection within a couple of minutes.
D. As long as he doesnt have a history of kidney disease, he should be able to take it.

 

 

____  10.   While visiting a friend who has recently been diagnosed with a brain tumor, the LPN notes the patient is receiving IV mannitol (Osmitrol). Which of the following will the nurse conclude based on the provision of this medication?

A. The medication is being given to increase sedation in preparation for brain surgery.
B. The client is at increased risk for liver dysfunction due to this medication.
C. The client may experience hypertension while on this medication.
D. The medication is being given to decrease swelling in the brain caused by the tumor.

 

 

____  11.   An LPN is caring for a client at the long-term care facility who has a history of heart failure and routinely takes furosemide (Lasix). The nurse will be most concerned by which of the following assessment findings?

A. The client has a urinary output of 1,900 mL in 24 hours.
B. The clients blood pressure is 124/68 mmHg.
C. The clients apical pulse is irregular.
D. The client has gained 3 pounds in 2 weeks.

 

 

____  12.   An LPN working with the Red Cross determines which of the following individuals will be ineligible to donate blood at this time?

A. A 64-year-old patient taking chlorthalidone (Hygroton)
B. A 55-year-old patient taking indapamide (Lozol)
C. A 61-year-old patient taking dutasteride (Avodart)
D. A 58-year-old patient taking chlorothiazide (Diuril)

 

 

____  13.   The LPN is providing care for a client in the long-term care facility who reports pain with urination and a frequent need to void. The nurse anticipates which of the following medications would be added to the clients treatment regimen?

A. Triamterene (Dyrenium)
B. Phenazopyridine (Pyridium)
C. Alfuzosin (Uroxatral)
D. Desmopressin (DDAVP)

 

 

____  14.   An LPN working in a rehabilitation center is assisting in the care of a client with a hip replacement that frequently has issues with incontinence. The client is started on oxybutynin (Ditropan). Which of the following statements indicates further teaching is necessary?

A. Im so glad they have a medication that can help me hold onto my urine longer. It is so embarrassing to lose control.
B. I am much more comfortable now that this medication has reduced my bladder spasms.
C. I seem to get more constipated now that Im taking this medication.
D. I know this medication might make my urine turn bright orange.

 

 

____  15.   The LPN working at a pediatricians office is talking to the mother of a 6-year-old patient who takes imipramine (Tofranil). The nurse would include which of the following statements in the client teaching?

A. Once your child starts taking this medication, her urinary tract infection should improve within a few days.
B. Avoid letting your child drink anything containing caffeine in the evening since it can irritate the bladder and increase bed-wetting.
C. This medication is given in the form of a patch that is changed once a week.
D. This medication acts on the loops of the kidney to alter the way fluid and electrolytes are exchanged.

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____    1.   An LPN is advising a friend who newly started taking birth control pills. Which of the following statements should the LPN include in the discussion? (Select all that apply.)

A. A barrier method of birth control should still be used to protect you from sexually transmitted diseases.
B. You will need to notify the doctor if you have any bleeding this month.
C. If you have any soreness in your legs or difficulty breathing, report to the physician right away.
D. Birth control pills release a chemical that kills sperm to prevent pregnancy.
E. Some people taking birth control pills have sore breasts and mild weight gain.

 

 

____    2.   An LPN working in a campus health center talks to a young woman about starting birth control pills. The young woman asks about side effects. Which of the following would be expected with this type of birth control?

A. Weight loss
B. Mood swings
C. Abdominal cramping
D. Increased libido
E. Breast tenderness
F. Blood clot formation

 

 

____    3.   The LPN working in a physician office determines which of the following clients would be appropriate for hormone replacement therapy with estrogen? (Select all that apply.)

A. A 52-year-old woman with vaginal dryness and hot flashes who has a negative surgical history
B. A 44-year-old woman s/p robotic hysterectomy for dysmenorrhea
C. A 68-year-old man with prostate cancer
D. A 28-year-old man with testicular cancer
E. A 35-year-old woman seeking oral birth control pills

 

 

____    4.   The nurse working on the labor and delivery special care unit is providing care for a woman who has been started on magnesium sulfate. The nurse would anticipate which of the following orders to be initiated as well? (Select all that apply.)

A. Place client on telemetry
B. Monitor vital signs every 2 to 4 hours
C. Strict intake and output
D. Check serum calcium and magnesium every 6 hours
E. Monitor serum amylase daily
F. Put patient in reverse isolation

 

 

____    5.   The LPN is talking to a friend who is considering infertility treatment with clomiphene (Clomid). The LPN is aware that this medication is associated with which of the following side effects? (Select all that apply.)

A. Multiple births
B. Headache
C. Flushing
D. Constipation
E. Ringing in the ears
F. Hypertension

 

 

____    6.   An LPN working at a family practice office identifies clients taking which of the following medications may experience decreased libido? (Select all that apply.)

A. Ranitidine (Zantac)
B. Diazepam (Valium)
C. Dexmethylphenidate (Focalin)
D. Clonidine (Catapres)
E. Propanolol (Inderal)
F. Warfarin (Coumadin)

 

 

____    7.   The LPN is aware that diuretic therapy may be included in the treatment plan for which of the following individuals? (Select all that apply.)

A. A 65-year-old patient with hypertension
B. A 40-year-old patient with acute kidney failure
C. A 51-year-old patient with bladder cancer
D. A 69-year-old patient with heart failure
E. A 74-year-old patient with glaucoma
F. A 49-year-old patient with diabetes

 

 

____    8.   The LPN is aware that potassium supplementation is an important component of treatment for clients taking which of the following? (Select all that apply.)

A. Spironolactone (Aldactone)
B. Furosemide (Lasix)
C. Chlorthalidone (Hygroton)
D. Bumetanide (Bumex)
E. Torsemide (Demadex)
F. Indapamide (Lozol)

 

Chapter 20. Reproductive and Urinary System Medications

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Contraceptive Medications (p. 366369; 369370): Levonorgestrel intrauterine device can be placed by a physician and left in place for up to 5 years. This device contains progestin and makes the uterus a very unwelcoming place for sperm. NuvaRing must be replaced each month, Transdermal patches are replaced weekly, and spermicides are used with each act of intercourse in conjunction with barrier methods of birth control.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Comprehension                              MSC:  NCLEX Category: Reduction of Risk Potential

NOT:  See Master the Essential Table and Hormone Replacement Therapy (p. 366369; 370371): Hormone replacement therapy has been shown to increase the risk of breast cancer, stroke, and blood clots.

 

  1. ANS:  B                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Analysis         MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Labor Medications (p. 366369; 372): Normal gestation is 40 weeks so this womans labor should most likely be started artificially. The use of dinoprostone as a gel inserted into the cervix to allow cervical ripening generally allows labor to start within about 6 hours.

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Labor Medications (p. 366369; 372): Pitocin is synthetic oxytocin used to stimulate uterine contractions. There is no association with uterine cancer, and this drug must be given in a controlled environment. Pitocin is used to encourage the labor process and ideally to prevent cesarean section.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Labor Medications (p. 366369; 372): Terbutaline is a bronchodilator but as a beta-blocker it also decreases uterine contractions and is used in preterm labor. Magnesium sulfate is used in the treatment of pre-eclampsia; no medication is needed for the woman with symptoms of early labor who is nearly full term; mifepristone (Mifeprex) is used to stop a pregnancy during the first 7 weeks since the last menstrual period.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Infertility Medications (p. 366369; 373): Menotropin is given by injection to stimulate follicle ripening and release. This treatment is indicated in women who have functional ovaries but in whom hormonal stimulation is lacking. There are side effects associated with fertility agents including multiple birth, headache, gynecomastia, flushing, and injection site tenderness. This agent is only used in the treatment of female infertility and would not be given to a male.

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Analysis         MSC:  NCLEX Category: Reduction of Risk Potential

NOT:  See Master the Essential Table and Medications to Treat Erectile Dysfunction, Libido and Infertility (p. 366369; 373374): Erectile dysfunction, or impotence, is a fairly common disorder frequently related to atherosclerosis, diabetes, stroke, and hypertension.

 

  1. ANS:  A                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Medications to Treat Erectile Dysfunction, Libido and Infertility (p. 366369; 373374): Sildenafil is used in the treatment of erectile dysfunction and works to dilate the arteries leading to the penis while constricting the veins, thereby sustaining an erection. These medications can be dangerous for patients with a history of cardiovascular disease, stroke, and sickle cell anemia.

 

  1. ANS:  A                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Medications to Treat Erectile Dysfunction, Libido and Infertility (p. 366369; 373374): Tadalifil is taken by mouth approximately 30 to 60 minutes prior to sexual activity and no more often than once a day to help attain and maintain an erection. It should not be taken if there is a history of cardiovascular disease, stroke, or sickle cell anemia.

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Diuretics (p. 366369; 374377): Mannitol is an osmotic diuretic given to patients with increased intracranial pressure related to head trauma, brain tumor, or other illness affecting the brain to reduce brain swelling. It can cause dizziness, eye pain, anorexia, confusion, and dehydration and must be given in a controlled environment.

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Diuretics (p. 366369; 374377): Furosemide is a loop diuretic that can cause potassium loss. Hypokalemia can result in irregular heart rhythms, and this is the highest concern for the scenario above. Normal urine output is 1,500 to 2,000 mL/day and Furosemide will cause increased diuresis. The listed blood pressure is within normal limits. Weight gain in a client with heart failure should be monitored closely but the priority in this question is the irregular heart rhythm.

 

  1. ANS:  C                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Drug Spotlight 20.1 (p. 366369; 378): Dutasteride is used in the treatment of benign prostatic hypertrophy. It prevents the conversion of testosterone to dihydrotestosterone. Due to the potential of birth defects, pregnant women should avoid handling this medication and men should wait 6 months after treatment ends to donate blood. The other medications listed are all thiazide diuretics and pregnancy is not a contraindication for use.

 

  1. ANS:  B                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Other Medications for Urinary Disorders (p. 366369; 377378): The listed symptoms are indicative of a urinary tract infection. Antibiotic therapy is appropriate along with Pyridium, which is a urinary analgesic. Triamterene is a potassium-sparing diuretic; alfuzosin is used in the treatment of BPH; desmopressin is used in the treatment of bed wetting.

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Other Medications for Urinary Disorders (p. 366369; 377378): Many medications may cause changes in urine color, but oxybutynin is not one of them. Pyridium is most known for turning urine a bright orange color. This medication is an anti-spasmodic that reduces bladder spasms and aids in the treatment of urinary incontinence by decreasing the sensation of urgency. Constipation is a listed side effect of this medication.

 

  1. ANS:  B                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Other Medications for Urinary Disorders (p. 366369; 377378): Desmopressin is a manufactured form of the naturally occurring hormone that helps control how the body uses water; it is given orally or as a nasal spray. Caffeine can irritate the bladder and should not be consumed after 6 p.m. to help avoid enuresis (bed-wetting).

 

MULTIPLE RESPONSE

 

  1. ANS:  A, C, E           PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Analysis         MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Contraceptive Medications (p. 366369; 369370): Birth control pills act by releasing hormones to mimic pregnancy. Barrier methods are the only effective method of birth control that also prevents sexually transmitted diseases. Risk for blood clot formation increases with birth control pills, so symptoms of a blood clot should be reported immediately. Other side effects include weight gain, sore breasts, and mood swings.

 

  1. ANS:  B, E, F            PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Contraceptive Medications (p. 366369; 369370): Birth control pills alter normal reproductive functioning so the body behaves like it is pregnant. Side effects include weight gain, mood swings, breast tenderness, and clot formation.

 

  1. ANS:  B, C               PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Analysis         MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Hormone Replacement Therapy (p. 366369; 370371): If a woman no longer has a uterus, estrogen is replaced because there is no buildup of the endometrial lining. If the woman still has her own uterus, estrogen is usually combined with progesterone so the risk of endometrial cancer development is not increased as it would be with estrogen alone. Estrogen decreases testosterone levels and can be used to treat prostate cancer. There is no role for estrogen in the treatment of testicular cancer.

 

  1. ANS:  A, B, C, D      PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Labor Medication (p. 366369; 372): Magnesium sulfate is commonly used to treat pre-eclampsia. Side effects include hypotension, cardiac arrhythmias, and weakness. It is thought this agent acts as a calcium channel blocker and magnesium toxicity is a potential risk so electrolytes should be monitored. Serum amylase is unrelated to this drug and there is no need for the client to be placed in reverse isolation as the risk of infection is not altered with this medication.

 

  1. ANS:  A, B, C           PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Infertility Medications (p. 366369; 373): Clomiphene is used for the treatment of female infertility and is associated with ovarian hyper-stimulation resulting in multiple births, headache, gynecomastia, injection site pain, and vasomotor flushing.

 

  1. ANS:  A, B, D, E      PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Reproductive and Urinary System Medications

KEY:  Application    MSC:  NCLEX Ca

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