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Pharm Ch 31-40 Questions with correct Answers 100% and detailed solutions
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Pharm Ch 31-40 Questions with correct Answers 100% and detailed solutions
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Pharm Ch 31-40ANS: A A patient taking a SERM must be informed to discontinue the drug 72 hours before and
during prolonged immobility so as to prevent the development of a thrombosis. - ✔✔12. A woman
who lives in Seattle is preparing to take a plane trip to London. She has been taking the SERM
raloxifene (Evista) for 6 months. The nurse will provide which instructions to this patient? a. She
needs to stop taking the drug at least 72 hours before the trip. b. She must remember to take this
drug with a full glass of water each morning. c. She will not take the drug while traveling on the plane.
d. No change in how the drug is taken will be needed.
ANS: A Administering penicillin reduces the vitamin K in the gut (intestines); therefore, enhanced
anticoagulant effect of warfarin may occur. The other options are incorrect. - ✔✔3. When reviewing
the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also
taking the oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an
interaction between these drugs? a. The penicillin will cause an enhanced anticoagulant effect of the
warfarin. b. The penicillin will cause the anticoagulant effect of the warfarin to decrease. c. The
warfarin will reduce the anti-infective action of the penicillin. d. The warfarin will increase the
effectiveness of the penicillin.
ANS: A Aminoglycosides are often used in combination with other antibiotics, such as beta-lactams or
vancomycin, in the treatment of various infections because the combined effect of the two antibiotics
is greater than that of either drug alone. - ✔✔5. A patient is receiving aminoglycoside therapy and
will be receiving a beta-lactam antibiotic as well. The patient asks why two antibiotics have been
ordered. What is the nurse's best response? a. "The combined effect of both antibiotics is greater
than each of them alone." b. "One antibiotic is not strong enough to fight the infection." c. "We have
not yet isolated the bacteria, so the two antibiotics are given to cover a wide range of
microorganisms." d. "We can give a reduced amount of each one if we give them together."
ANS: A Androgens, when used with oral anticoagulants, can significantly increase or decrease
anticoagulant activity. The other options are incorrect. - ✔✔8. The nurse is reviewing the medication
list of a patient who will be starting androgen therapy. Which drug classes, if taken with androgens,
may have an interaction with them? a. Oral anticoagulants b. Nitrates c. Beta blockers d. Proton
pump inhibitors
ANS: A Basal-bolus therapy is the attempt to mimic a healthy pancreas by delivering basal insulin
constantly as a basal, and then as needed as a bolus. Glargine insulin is used as a basal dose, not
as a bolus with meals. Basal-bolus therapy is a newer therapy; historically, sliding-scale coverage
was implemented - ✔✔19. The nurse is teaching a group of patients about management of diabetes.
Which statement about basal dosing is correct? a. "Basal dosing delivers a constant dose of insulin."
,b. "With basal dosing, you can eat what you want and then give yourself a dose of insulin." c.
"Glargine insulin is given as a bolus with meals." d. "Basal-bolus dosing is the traditional method of
managing blood glucose levels."
ANS: A Drug-related photosensitivity occurs when patients take tetracyclines, and it may continue for
several days after therapy. Milk and cheese products result in decreased levels of tetracycline when
the two are taken together. Antacids also interfere with absorption and should not be taken with
tetracycline. Counsel patients to take the entire course of prescribed antibiotic drugs, even if they feel
that they are no longer ill. - ✔✔2. The nurse is providing teaching to a patient taking an oral
tetracycline antibiotic. Which statement by the nurse is correct? a. "Avoid direct sunlight and tanning
beds while on this medication." b. "Milk and cheese products result in increased levels of
tetracycline." c. "Antacids taken with the medication help to reduce gastrointestinal distress." d. "Take
the medication until you are feeling better."
ANS: A Expectorants such as guaifenesin work to loosen and thin sputum and the bronchial
secretions, thereby indirectly diminishing the tendency to cough. The other drugs listed do not have
this effect. - ✔✔6. A patient with a tracheostomy has difficulty removing excessive, thick mucus from
the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of
mucus? a. Guaifenesin (Humibid) b. Benzonatate (Tessalon Perles) c. Diphenhydramine (Benadryl)
d. Dextromethorphan (Robitussin DM)
ANS: A First-generation cephalosporins provide excellent coverage against gram-positive bacteria
but limited coverage against gram-negative bacteria. - ✔✔9. The nurse is reviewing the sputum
culture results of a patient with pneumonia and notes that the patient has a gram-positive infection.
Which generation of cephalosporin is most appropriate for this type of infection? a. First generation b.
Second generation c. Third generation d. Fourth generation
ANS: A Fluid retention is an undesirable effect of androgens. The other options are incorrect. - ✔✔2.
When a male patient is receiving androgen therapy, the nurse will monitor for signs of excessive
androgens such as: a. fluid retention. b. dehydration. c. restlessness. d. visual changes.
ANS: A Forcing fluids helps to loosen and liquefy secretions. The patient must be fully aware that any
fever, chest tightness, change in sputum from clear to colored, difficult or noisy breathing, activity
intolerance, or weakness needs to be reported. The patient must also report to the prescriber a fever
of higher than 100.4° F (38° C) or symptoms that last longer than 3 to 4 days. Decongestants do not
cause sedation, and therefore the patient does not need to avoid driving a car or operating heavy
machinery. - ✔✔4. A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection.
Which instruction will the nurse include during patient teaching? a. Force fluids to help loosen and
liquefy secretions. b. Report clear-colored sputum to the prescriber. c. Avoid driving a car or operating
heavy machinery because of the sedating effects. d. Report symptoms that last longer than 2 days.
, ANS: A Glipizide is taken in the morning, 30 minutes before breakfast. When taken at this time, it has
a longer duration of action, causing a constant amount of insulin to be released. This may be
beneficial in controlling blood glucose levels throughout the day. - ✔✔5. A 75-year-old woman with
type 2 diabetes has recently been placed on glipizide (Glucotrol), 10 mg daily. She asks the nurse
when the best time would be to take this medication. What is the nurse's best response? a. "Take this
medication in the morning, 30 minutes before breakfast." b. "Take this medication in the evening with
a snack." c. "This medication needs to be taken after the midday meal." d. "It does not matter what
time of day you take this medication."
ANS: A Headache is one of the possible adverse effects of the fertility drugs. They may also cause
vomiting, restlessness, and urticaria. Drowsiness, dysmenorrhea, and hypertension are not potential
adverse effects. See Table 34-5 for other adverse effects. - ✔✔4. The nurse is teaching a patient
about the adverse effects of fertility drugs such as clomiphene (Clomid). Which is a potential adverse
effect of this drug? a. Headache b. Drowsiness c. Dysmenorrhea d. Hypertension
ANS: A If possible, it is best to administer thyroid drugs taken once daily in the morning so as to
decrease the likelihood of insomnia that may result from evening dosing. - ✔✔7. A patient, newly
diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The
nurse will instruct the patient to take this medication at which time of day? a. In the morning b. With
the noon meal c. With the evening meal d. At bedtime
ANS: A Intravenous acyclovir is stable for 12 hours at room temperature and often precipitates when
refrigerated. Intravenous infusions must be diluted as recommended (e.g., with 5% dextrose in water
or normal saline) and infused with caution. Infusion over longer than 1 hour is suggested to avoid the
renal tubular damage seen with more rapid infusions. Adequate hydration should be encouraged
(unless contraindicated) during the infusion and for several hours afterward to prevent drug-related
crystalluria. - ✔✔5. The nurse is administering intravenous acyclovir (Zovirax) to a patient with a viral
infection. Which administration technique is correct? a. Infuse intravenous acyclovir slowly, over at
least 1 hour. b. Infuse intravenous acyclovir by rapid bolus. c. Refrigerate intravenous acyclovir. d.
Restrict oral fluids during intravenous acyclovir therapy.
ANS: A Nervousness, tremors, and cardiac stimulation are possible and expected adverse effects of
beta agonists. The other options are incorrect responses. - ✔✔5. After receiving a nebulizer
treatment with a beta agonist, the patient complains of feeling slightly nervous and wonders if her
asthma is getting worse. What is the nurse's best response? a. "This is an expected adverse effect.
Let me take your pulse." b. "The next scheduled nebulizer treatment will be skipped." c. "I will notify
the physician about this adverse effect." d. "We will hold the treatment for 24 hours."
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