Pharmacology Questions

Chapter 18

Pharmacology Questions

126. The nurse is instructing a client about quinapril hydrochloride (Accupril). The nurse should make which statement to the client?

1. To take the medication with food only

2. To rise slowly from a lying to a sitting position

3. To discontinue the medication if nausea occurs

4. That a therapeutic effect will be seen immediately

Level of Cognitive Ability:

Client Needs:

Physiological Integrity

Integrated Process:

Teaching and Learning

Content Area:

ANSWER: 2

Rationale:

Quinapril hydrochloride (Accupril) is an angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension. The client should be instructed to rise slowly from a lying to a sitting position and to permit the legs to dangle from the bed momentarily before standing to reduce the hypotensive effect. The medication may be given without regard to food. The client should be instructed to drink a noncaffeinated carbonated beverage and eat crackers or dry toast if nauseated. A full therapeutic effect may occur in 1 to 2 weeks.

Test-Taking Strategy:

Eliminate option 1 because of the closed-ended word only and option 4 because of the word immediately. Next focus on the name of the medication, and recall that most ACE inhibitor medication names end with the letters –pril and that these medications are used to treat hypertension. This will direct you to the correct option. Review: quinapril hydrochloride (Accupril).

Tip for the Beginning Nursing Student:

Hypertension refers to an elevated blood pressure and is a known cardiovascular risk factor. ACE inhibitor medications are one class of medications used to treat hypertension. Because medication used to treat hypertension lowers the blood pressure, lightheadedness and dizziness can occur. Therefore, it is important for the nurse to teach the client safety measures. You will learn about ACE inhibitors in your pharmacology course and in your medical-surgical nursing course when you study cardiovascular disorders.

References

Hodgson, Kizior (2013), p. 993; Lehne (2013), p. 512.

127. The nurse notes that a client is receiving ganciclovir sodium (Cytovene). The nurse suspects that the client is receiving this medication for the treatment of which disorder?

1. Pancreatitis

2. Urolithiasis

3. Nephrotic syndrome

4. Cytomegalovirus retinitis

Level of Cognitive Ability:

Client Needs:

Physiological Integrity

Integrated Process:

Nursing Process/Assessment/Data Collection

Content Area:

ANSWER: 4

Rationale:

Ganciclovir sodium (Cytovene) is an antiviral medication used to treat cytomegalovirus (CMV) retinitis in immunocompromised clients and CMV gastrointestinal infections and pneumonitis; it is also used to prevent CMV disease in transplant clients. It is not used to treat pancreatitis, urolithiasis, or nephrotic syndrome.

Test-Taking Strategy:

Note the subject, the intended effect of ganciclovir sodium. Focus on the name of the medication. Recalling that most antiviral medications names contain the letters vir will direct you to the correct option. Review: ganciclovir sodium (Cytovene).

Tip for the Beginning Nursing Student:

Cytomegalovirus retinitis is an infection of the retina caused by a herpes type of virus. Pancreatitis is an inflammatory condition of the pancreas that can be acute or chronic. Urolithiasis refers to the presence of calculi (stones) in the urinary system. Nephrotic syndrome is an abnormal condition of the kidney characterized by marked proteinuria, hypoalbuminemia, and edema. You will learn about cytomegalovirus retinitis, pancreatitis, and urolithiasis in your medical-surgical nursing course and about nephrotic syndrome in your pediatric nursing course.

References

Hodgson, Kizior (2013), pp. 526-527; Lehne (2013), pp. 1169, 1206-1207.

128. The nurse is teaching a client how to mix Humulin R and Humulin N insulin in the same syringe. Which instruction should be included?

1. Draw up Humulin R first into the syringe.

2. Take all air out of the bottle before mixing.

3. Shake the Humulin N bottle before mixing.

4. Keep both bottles stored in the refrigerator for 1 month.

Level of Cognitive Ability:

Client Needs:

Physiological Integrity

Integrated Process:

Teaching and Learning

Content Area:

ANSWER: 1

Rationale:

Before mixing different types of insulin, the bottle should be rotated for at least 1 minute between both hands. This resuspends the insulin and helps warm the medication. The nurse should not shake the bottles. Shaking causes foaming and bubbles to form, which may trap particles of insulin and alter the dosage. Insulin may be maintained at room temperature. Additional bottles of insulin should be stored in the refrigerator for future use. Humulin R is drawn up before Humulin N. Air does not need to be removed from the insulin bottle.

Test-Taking Strategy:

Note the subject, the procedure for mixing Humulin R and Humulin N in the same syringe. Visualize the procedure as you carefully read each option. When answering questions that relate to mixing insulin remember the letters RN—draw Humulin R into the syringe before Humulin N. Review: the procedures for administering insulin.

Tip for the Beginning Nursing Student:

Insulin is a medication used to treat diabetes mellitus, a disorder of fat, carbohydrate, and protein metabolism. Humulin R is short-acting insulin, and Humulin N is an intermediate-acting insulin. When both types of insulin are prescribed they can be mixed together in one syringe so that only one injection is necessary. There is a specific procedure for mixing these types of insulin, which you will learn when you learn about injections in your fundamentals course and when you study pharmacology.

References

deWit, Kumagai (2013), p. 864; Lewis et al (2011), p. 1227.

129. A client has been taking lansoprazole (Prevacid). The nurse should monitor the client for the relief of which symptom?

4. Constipation

Level of Cognitive Ability:

Client Needs:

Physiological Integrity

Integrated Process:

Nursing Process/Evaluation

Content Area:

ANSWER: 2

Rationale:

Lansoprazole (Prevacid) is a gastric pump inhibitor (proton pump inhibitor). Its intended effect is relief of gastric irritation pain, often referred to as heartburn. The medication does not improve diarrhea, flatulence, or constipation.

Test-Taking Strategy:

Note the subject, intended effects of lansoprazole (Prevacid). Focus on the words relief of. Note the name of the medication, and recall that most proton pump inhibitor medication names end with the letters –zole. This will direct you to the correct option. Review: lansoprazole (Prevacid).

Tip for the Beginning Nursing Student:

Heartburn is a painful burning sensation in the esophagus. It is usually caused by the reflux of gastric acid into the esophagus. Proton pump inhibitors are one type of medication used to treat heartburn. You will learn about heartburn when you study gastrointestinal disorders in your medical-surgical nursing course and about proton pump inhibitors when you study pharmacology.

References

deWit, Kumagai (2013), p. 647; Lehne (2013), p. 999.

130. A client is taking amiloride hydrochloride (Midamor) daily. The nurse should tell the client to take the dose at what time?

2. On an empty stomach

3. Between lunch and dinner

4. In the morning with breakfast

Level of Cognitive Ability:

Client Needs:

Physiological Integrity

Integrated Process:

Teaching and Learning

Content Area:

ANSWER: 4

Rationale:

Amiloride hydrochloride (Midamor) is a potassium-retaining diuretic used to treat edema or hypertension. A daily dose should be taken in the morning to avoid nocturia. The dose should be taken with food to increase bioavailability.

Test-Taking Strategy:

Eliminate options 1, 2, and 3 because they are comparable or alike in that they all indicate taking the medication dose without food. Review: amiloride hydrochloride (Midamor).

Tip for the Beginning Nursing Student:

Edema is the abnormal accumulation of fluid in body tissues. Hypertension refers to an elevated blood pressure and is a known cardiovascular risk factor. Potassium-retaining diuretics are one class of medications used to treat edema or hypertension. Only a few medications are potassium-retaining, and amiloride is one of them. A concern with potassium-retaining diuretics is that the client retains potassium, which can lead to hyperkalemia (a high potassium level). Therefore, the nurse monitors the client for signs of hyperkalemia. You will learn about potassium-retaining diuretics when you study pharmacology.

References

deWit, Kumagai (2013), p. 696; Hodgson, Kizior (2013), p. 102.

131. The nurse is caring for a client with a diagnosis of rheumatoid arthritis who is receiving aspirin (acetylsalicylic acid, ASA) 5 g orally daily. The nurse recognizes which finding as an adverse effect related to the medication?

3. Urinary retention

4. Difficulty voiding

Level of Cognitive Ability:

Client Needs:

Physiological Integrity

Integrated Process:

Nursing Process/Assessment/Data Collection

Content Area:

ANSWER: 1

Rationale:

Aspirin is a nonsteroidal anti-inflammatory drug. Adverse effects include gastrointestinal bleeding or gastric mucosal lesions, ringing in the ears (tinnitus), or generalized pruritus. Headache, dizziness, flushing, tachycardia, hyperventilation, sweating, and thirst are also adverse effects. Options 2, 3, and 4 are not adverse effects. In addition, aspirin is administered to the client with rheumatoid arthritis to relieve joint pain.

Test-Taking Strategy:

Focus on the subject, an adverse effect of aspirin. Eliminate options 3 and 4 first because they are comparable or alike. Next eliminate option 2 because aspirin is administered to relieve joint pain. Last, remembering that aspirin can cause gastrointestinal disturbances and ototoxicity will direct you to the correct option. Review: aspirin.

Tip for the Beginning Nursing Student:

Arthritis is an inflammatory condition of the joints characterized by pain, swelling, heat, redness, and limitation of movement. It can affect the client’s ability to perform activities of daily living and result in debilitation. Arthritis can occur in childhood or adulthood. Large doses of aspirin may be administered to alleviate the joint pain. However, aspirin can cause gastrointestinal bleeding, ringing in the ears (tinnitus), or generalized pruritus. You will learn about the effects of aspirin when you study pharmacology, and you will learn about arthritis in your pediatrics and medical-surgical nursing courses.

References

Hodgson, Kizior (2013), p. 85; Lehne (2013), p. 907.

132. The nurse is preparing a plan of care for a client who is receiving meperidine hydrochloride (Demerol) for pain. The nurse should include in the plan to monitor for which adverse effect of this medication?

3. Flushed face

4. Skeletal muscle flaccidity

Level of Cognitive Ability:

Client Needs:

Physiological Integrity

Integrated Process:

Nursing Process/Planning

Content Area:

ANSWER: 4

Rationale:

Frequent side effects of this medication include sedation, decreased blood pressure, diaphoresis, flushed face, dizziness, nausea, vomiting, and constipation. Adverse effects include respiratory depression; skeletal muscle flaccidity; cold and clammy skin; cyanosis; and extreme somnolence progressing to convulsions, stupor, and coma.

Test-Taking Strategy:

Focus on the subject, an adverse effect, and recall that meperidine hydrochloride (Demerol) is an opioid analgesic. Recalling that an adverse effect is more severe than a side effect and is always an undesirable effect will direct you to the correct option. Review: the adverse effects of meperidine hydrochloride (Demerol).

Tip for the Beginning Nursing Student:

Meperidine hydrochloride (Demerol) is an opioid analgesic that is used to alleviate pain that occurs in many types of disorders. Because it is an opioid analgesic it will cause skeletal muscle flaccidity, which can place the client at risk for injury. Another critical adverse effect of opioid analgesics is that they cause respiratory depression so assessment of respiratory status is an important part of your nursing interventions. You will learn about meperidine hydrochloride (Demerol) and other opioid analgesics in a pharmacology course or in your medical-surgical nursing course.

References

Christensen, Kockrow: Adult health (2011), p. 255; Hodgson, Kizior (2013), pp. 734-735.

133. Theophylline (Theo-24) is prescribed for a client with bronchial asthma. The nurse provides dietary instructions to the client and should tell the client to avoid consuming which item?

3. Orange juice

4. Tomato juice

Level of Cognitive Ability:

Client Needs:

Physiological Integrity

Integrated Process:

Teaching and Learning

Content Area:

ANSWER: 1

Rationale:

The client is instructed to avoid the use of products that contain caffeine, such as cola, coffee, tea, and chocolate because caffeine could lead to an increased incidence of cardiovascular and central nervous system side/adverse effects of the medication. The items in options 2, 3, and 4 are acceptable to consume.

Test-Taking Strategy:

Recall that medication names that end with the letters –line are xanthine bronchodilators and that these medications can cause cardiovascular and central nervous system side/adverse effects. Also, eliminate options 2, 3, and 4 because they are comparable or alike in that they are fruit drinks. Review: the items to be avoided by a client taking a xanthine bronchodilator.

Tip for the Beginning Nursing Student:

Theophylline (Theo-24) is a xanthine bronchodilator that dilates bronchial airways and pulmonary blood vessels and is used to treat respiratory disorders, such as bronchial asthma, bronchitis, emphysema, chronic obstructive pulmonary disease, or bronchospasm. An important point to remember is that these medications can cause cardiovascular and central nervous system side/adverse effects, particularly if taken with caffeine-containing products. Therefore, an important teaching point is to tell the client to avoid caffeine-containing products. In addition, another important intervention is to monitor the client for changes in the cardiovascular or central nervous system. You will learn about theophylline (Theo-24) in a pharmacology course or in your medical-surgical nursing course when you study respiratory disorders.

References

Hodgson, Kizior (2013), p. 1132; Lehne (2013), pp. 967, 976.

134. The nurse is providing instructions to a client about lithium carbonate that has been prescribed for acute mania. The nurse should provide which information to the client?

1. Foods that contain salt need to be avoided.

2. Medication blood levels need to be checked yearly.

3. Vomiting and diarrhea are expected effects of the medication.

4. Blurred vision needs to be reported to the health care provider.

Level of Cognitive Ability:

Client Needs:

Physiological Integrity

Integrated Process:

Teaching and Learning

Content Area:

ANSWER: 4

Rationale:

Because therapeutic and toxic dosage ranges are so close, lithium blood levels must be monitored closely (every 3 or 4 days at the initiation of therapy and then every 1 to 2 months). The client should be instructed to notify the health care provider if excessive diarrhea, vomiting, blurred vision, or other signs of toxicity occur. A normal diet and normal salt and fluid intake (1500 to 3000 mL per day of fluid) should be maintained because lithium decreases sodium reabsorption in the renal tubules, which could cause sodium depletion. A low sodium intake causes an increase in lithium retention and could lead to toxicity.

Test-Taking Strategy:

Focus on the subject, client instructions regarding lithium carbonate. Recall the action of this medication and that toxicity is a concern with its use. This will direct you to the correct option. Also eliminate options 1, 2, and 3 because of the words avoided, yearly, and are expected, respectively, in these options. Review: the client teaching points related to the administration of lithium carbonate.

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Jul 24, 2016 | Posted by admin in NURSING | Comments Off

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