NR 447 RN Capstone Pharmacology Questions and Answers
2021
1.A nurse is caring for a client with many different medications who is newly prescribed
acetazolamide. What medications can interact with acetazolamide?
Serious effects such as metabolic acidosis can occur in clients using high dose aspirin.
Acetazolamide can increase the risk of toxic effects of quinidine.
Acetazolamide can decrease blood levels of lithium.
Acetazolamide can increase osteomalacia an adverse effect of phenytoin.
Sodium bicarbonate increases the risk of kidney stones.
2.What class of medication is amitriptyline and why is this medication used as an adjuvant medication
for pain?
Amitriptyline is a tricyclic antidepressant.
It is indicated for chronic pain syndromes such as fibromyalgia, neuropathic/chronic pain,
headache, and low back pain.
3.A nurse is preparing to administer ipratropium by metered dose inhaler. What adverse effects
should the nurse instruct the client to monitor for?
The nurse should inform the patient about local anticholinergic effects such as dry mouth,
hoarseness, the nurse can advise the patient to sip fluids or suck hard candies to control dry mouth.
4.A nurse is caring for a client with asthma who asks if montelukast sodium can be taken for acute
asthma symptoms. When should montelukast sodium be taken?
Take once every evening even if no symptoms occur to help prevent and manage asthma symptoms.
5.A nurse is caring for a client prescribed the inhaled glucocorticoid beclomethasone (QVAR) for the
treatment of asthma. What is a potential adverse effect of this medication and what are two (2)
teaching points to discuss to address these adverse effects?
Difficulty speaking hoarseness and candidiasis these are potential adverse effects of the
medications.
• Advise clients to rinse mouth or gargle with water after use.
• Advise clients to monitor for redness sores or white patches and to report to provider if they
occur treat candidiasis with nystatin oral suspension.
6.A nurse is instructing a client who has a new prescription for nitroglycerin transdermal patch
about administration. What instructions should the nurse include?
The nitroglycerin patch works by relaxing (widening) blood vessels. This patch is for external use
only. Apply the patch at the same time every day; apply to a hairless area of the chest, inner side of
the upper arm, back or shoulder. Clean and dry skin completely before applying the patch. Do not
apply the patch to irritated or damaged skin. When removing the patch, fold it with sticky sides
together to prevent administration of medicine to someone that may handle the patch. The patch
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, should only be worn for 12-14 hours per day so that you will have a 10-12 hour nitrate free period
each day. If you miss a dose, use the next dose as soon as possible.
7.A nurse is administering a unit of packed red blood cells (PRBCs) to a client. What symptoms
would indicate circulatory overload? Name three (3) clinical manifestations of circulatory overload.
What are three (3) interventions the nurse can take action on if overload occurs?
Clinical Manifestations: Cough, shortness of breath, crackles, hypertension, tachycardia and
distended neck veins.
• Observe for manifestations of fluid excess.
• In older adults or clients at risk for overload, transfuse 1 unit of PBC's over two to four hours
avoiding any concurrent fluid infusion into another IV site. Monitor vital signs every 15
minutes throughout transfusion. If possible wait two hours between units of blood when
multiple units have been prescribed.
• If manifestations occur stop the transfusion, place the client in sitting position with legs
down and notify provider.
• Administer diuretics and oxygen as appropriate
• Monitor I&O
• Prior to any transfusion assess kidney respiratory and cardiovascular function for risk of
overload.
8.A nurse is preparing to administer a topoisomerase inhibitor to a client with ovarian cancer. What
are adverse effects the nurse should monitor when administering this medication?
• Bone marrow suppression
• GI Discomfort (nausea and vomiting )
• Alopecia
9.A nurse has provided education to a client has a new prescription for exenatide. What statements
by the client would indicate they understand the instructions?
• "I will contact my doctor if I have trouble swallowing, a lump or swelling in my neck,
hoarseness, or shortness of breath, stomach or back pain, or nausea and vomiting.”
• “Exenatide lowers my blood sugar by increasing the release of insulin from my pancreas. “
• “I will not use exenatide if the product looks discolored, or if the vial is cracked or
damaged.”
• “I will inject exenatide deep under the skin in the stomach area, upper leg or upper arm as
directed by my doctor. I will not inject exenatide into a vein or muscle, and I will use it once
a week.”
• “I will store the medication without the needle attached, and I will discard the needle in a
safe place(such as a coffee tin) after each use and label the tin appropriately to avoid others
being stuck.”
• “I will use this medication immediately after it is mixed.”
This study source was downloaded by 100000825079977 from CourseHero.com on 07-17-2021 02:32:44 GMT -05:00
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