NURS 6521 ADVANCED PHARMACOLOGY FINAL EXAM

NURS 6521 ADVANCED PHARMACOLOGY FINAL EXAM The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day? Selected Answer: 1500 mg A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug? Selected Answer: Lid margin crusting and pruritus A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize? Selected Answer: The peak and trough blood levels A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered? Selected Answer: Protamine sulfate A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered Selected Answer: phytoestrogens. An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug? Selected Answer: Infuse the drug over 2 to 4 hours into a central line using an infusion pump The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children? Selected Answer: Having nurses check their math calculations with a colleague before administering a drug. A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse's evaluation of the increase is that Selected Answer: the increase in the neutrophil count is only transient. A nurse practitioner has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug? Selected Answer: A 19-year-old male receiving radiotherapy A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to Selected Answer: complete the entire course of drug therapy. Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid Selected Answer: alcohol. A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend Selected Answer: tylenol. After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from Selected Answer: clomiphene. A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the Selected Answer: ventrogluteal muscle. A woman is receiving prolonged drug therapy during her complicated pregnancy, and it may pose a risk to both the mother and the fetus. The primary care physician has made dosage adjustments to minimize adverse effects and prevent toxicity. The nurse should make sure Selected Answer: that serum levels of the drug are being monitored. A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take Selected Answer: antacids not less than 1 hour before or 2 hours after taking INH. The recommended treatment for trichomoniasis is Selected Answer: Flagyl. A Nurse Practitioner is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules crossing the placental membrane and entering into the fetal circulation. The nurse tells the patient that the main reason this happens is because Selected Answer: drugs compete with the hormones of pregnancy for albumin- binding sites. A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective? Selected Answer: The patient's hemoglobin level is 11 g/dL A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient is? Selected Answer: Anxiety related to perceived danger of drug therapy to fetus or infant A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic hypertrophy (BPH). When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy? Selected Answer: Prostatic neoplasia A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it occur? Selected Answer: Presence of blood in urine or stools A 71-year-old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicated a need for this drug? Selected Answer: "Lately, I have to get up three or four times a night to go to the bathroom." A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? Selected Answer: That the infant's skin has greater permeability than that of an adult A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following? Selected Answer: Neurotoxicity A Nurse Practitioner will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months? Selected Answer: Liver function tests A patient has acquired primary hypogonadism and has been prescribed testosterone transdermal (Androderm) patches. When educating the patient on how to administer the drug, the nurse will instruct him to Selected Answer: place the patch on the back, abdomen, upper arms, or thighs. A Nurse Practitioner is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman's care provider to prescribe a bisphosphonate? Selected Answer: Low bone density and a family history of osteoporosis A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate? Selected Answer: Hepatic function A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor Selected Answer: plasma concentrations regularly. Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to Selected Answer: stand or sit upright for at least 30 minutes after taking alendronate.. Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of Selected Answer: cardiac arrhythmias. A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause Selected Answer: staining of permanent teeth. A Nurse Practitioner is caring for a patient who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize? Selected Answer: Fetal heart rate (FHR) The nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effects is highest during Selected Answer: the first 2 months of pregnancy. A patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi's sarcoma. As a result of this most recent diagnosis, his care team has opted to begin treatment with interferon alfa-2a. The nurse is aware that this drug will address the etiology of Kaposi sarcoma by Selected Answer: inhibiting tumor growth by enhancing inflammation. Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent Selected Answer: once a day. A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of Selected Answer: weekly subcutaneous injections. Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim? Selected Answer: "Do you feel like you're having any pain in your bones?" Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen? Selected Answer: Headaches and chest pain A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should Selected Answer: offer a choice between liquid and chewable medications, if possible. A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem? Selected Answer: Hypertensive crisis A Nurse Practitioner is going to administer medication to an infant using a medicine dropper. The best method is to open the child's mouth by gently squeezing the cheeks and placing the drops Selected Answer: in the buccal pouch. A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient's childbearing potential. The nurse will inform the patient that during sibutramine therapy she should Selected Answer: use adequate contraception. A pregnant patient who has diabetes has been admitted to the hospital to begin labor. Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor contractions. When talking to the patient about the adverse effects of the drug, the nurse should understand that the most common adverse effects of the drug include Selected Answer: uterine tachysystole. A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to Selected Answer: both the boy and his mother regarding all medication issued. A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient's care to include close monitoring of the drug therapy because Selected Answer: the patient is at greater risk for high serum levels of the drug. A 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain along with a local disease flare. The nurse interprets this as an indication of which of the following? Selected Answer: The tumor responding to treatment A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? Selected Answer: The use of ciprofloxacin is contraindicated in pregnancy. A Nurse Practitioner is having difficulty administering a bitter drug to a 5-year-old child. The nurse should Selected Answer: offer the child a flavored ice chip or ice pop prior to administering the drug. A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend? Selected Answer: Acetaminophen A Nurse Practitioner is reviewing the prepregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of which of the following changes in pharmacokinetics that accompanies pregnancy? Selected Answer: Increased drug distribution resulting from hemodynamic changes On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate? Selected Answer: "It's important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke" Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug Selected Answer: Schedule 2 to scalp. A child is taking permethrin for head lice. The Nurse Practitioner will instruct her mother Selected Answer: stop using creams, ointments, and oils on the child's skin and