NURS 6521 Pharmacy Final Exam 2023

NURS 6521 Pharmacy Final Exam/ Walden University/ Questions and Answers/ 41. A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.: Is there a need for the drug in treating the presenting problem? Is this the best drug for the presenting problem? Can the patient take the prescribed drug? 42. An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pul- monary edema?: Furosemide (Lasix) 43. In order to promote therapeutic drug effects, the nurse should always encourage patients to: take their medication at the prescribed times. 44. The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day?: 1500 mg 45. A patient with mild low back pain has been advised to take aceta- minophen. The nurse will inform him that excessive intake of acetaminophen may result in: liver damage 46. A nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?: Taking several drugs simultane- ously 47. A nurse is aware that diphenoxylate HCl with atropine sulfate is an effective adjunct in the treatment of diarrhea. For which of the following patients could the administration of this drug be potentially harmful?: An 80-year-old man who has diarrhea secondary to Clostridium difficile infection 48. A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient's daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that...: a dose adjustment should be made if these symptoms persist. 49. An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain?: Twice-daily doses of long-acting morphine, with short-acting morphine available for breakthrough pain 50. A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assess- ment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient's drug therapy?: vascular impairment 51. A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 cg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments?: Blood Pressure (BP) 52. Prior to administering a dose of 5-FU to a patient with pancreatic cancer, the nurse is conducting the necessary drug research. The nurse is aware that 5-FU is a cell cycle-specific chemotherapeutic agent. Which of the following state- ments best describes cell cycle-specific drugs?: They affect cancerous cells during a particular phase of cellular reproduction. 53. Which of the following would be the most important safety-related in- struction for a nurse to give to a patient taking baclofen (Lioresal)?: Discontinue the use of alcohol 54. A nurse is assessing a patient who has come to the emergency depart- ment complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that "puts me at risk of becoming physically dependent." Which of the following medications would the nurse question, if ordered?: Cyclobenzaprine (Flexeril) 55. A patient with bronchial asthma is prescribed a sustainedrelease prepa- ration of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest?: Take it on an empty stomach, 1 hour before or 2 hours after meals 56. A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond apprecia- bly to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient's subsequent care, what nursing diagnosis should the nurse prioritize?: Risk for Injury related to drug-drug interactions or drug-nutrient interactions 57. Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion?: BULK-FORMING (fiber) LAXATIVES 58. What critical piece of information is missing from the following medica- tion order: Amoxicillin 250 mg every 8 hours?: Routes of Administration 59. The nurse practitioner orders Amoxicillin 250 mg/5 ml tid for 10 days? The nurse practitioner would expect the pharmacist to fill the prescription bottle with how many ml?: 150 ml 60. A 77-year-old woman who is 5 feet 3 inches tall and weighs 89 lbs has been admitted to the hospital with a diagnosis of failure to thrive. What action should the nurse prioritize when addressing the woman's apparent lack of nutrition?: Assess the reasons behind the patient's poor nutritional status 61. A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of: Hypertension 62. A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to...: swallow the tablet with milk or food. 63. A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of: an adrenergic antagonist 64. A patient is brought to the emergency department in hypertensive crisis. Nitroprusside is administered intravenously. The patient experiences di- aphoresis and dizziness. Which of the following is the appropriate action by the nurse?: Slow the rate of the infusion 65. A nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient's care?: Acute Pain, Headache, related to adverse effects of drug therapy 66. A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?: This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue. 67. A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?: The man may be experiencing nephrotoxic effects of aspirin 68. A nurse who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipi- demics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients?: An obese male client who is a heavy alcohol user and who has cirrhosis of the liver 69. A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?: "Quit- ting smoking will significantly increase the chance that this drug will heal your ulcer." 70. A 47-year-old woman has been diagnosed with openangle glaucoma. Pilocarpine drops are prescribed. The nurse's assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to: remove the contact lenses before applying the drops. 71. It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy?: Blood ammonia levels 72. A nurse is a member of a research team that is exploring unique dif- ferences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called: pharmacodynamics. 73. A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?: "Drugs do not cure these disorders; they instead enhance quality of life." 74. A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the patient to: notify the clinic if the stools are black or if there is evidence of blood. 75. An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient's risk of severe nausea, the nurse should: administer a combination of antiemet- ics prior to the administration of the drug. 76. A nurse is assessing a female patient who is taking diphenoxylate HCl with atropine sulfate. Which of the following would lead the nurse to suspect that she is experiencing an allergic reaction?: Urticaria (hives) 77. Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?: The resident's apical heart rate is 112 beats/minute with a regular rhythm 78. A 40-year-old woman with a diagnosis of fibromyalgia has been pre- scribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?: Risk for Injury related to CNS depressant effects 79. A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure out- side a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin?: The patient's protein deficit will likely increase the levels of the free drug in his blood. 80. A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically?: Height 81. A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe's medicine man perform a ritual before the patient goes to surgery. The nurse's response to this request should be: As long as the ritual does not interfere with the patient's preoperative care, it will be okay. 82. A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for: dizziness 83. A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?: Carefully assess the patient for infec- tions 84. A patient with a diagnosis of nonsmall cell lung cancer is currently undergoing chemotherapy. At the encouragement of a family member, the patient has announced to the nurse his intention to complement this treatment with a regimen of herbal remedies. How should the nurse respond to this patient's statement?: "It's important to discuss what herbs you'll be taking with your doctor or the pharmacist to make sure there aren't any interactions." 85. Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about: - potential adverse effects of the drugs that Mr. Nguyen will be taking. 86. A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose?: The amount of alcohol consumption 87. A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states: Many medications can be potentially harmful if taken by someone other than the person the medication was prescribed. 88. Several months of treatment with a statin accompanied by lifestyle mod- ifications have failed to appreciably improve a patient's cholesterol levels. Conse- quently, the patient has been prescribed cholestyramine. The nurse should recognize that this drugs achieves its therapeutic effect by: oxidizing cholesterol to bile acids. 89. A patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note the: skin surrounding the potential IV site. 90. A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?: Digoxin immune fab 91. A 76-year-old woman has a complex medical history that includes emphy- sema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by: her history of emphysema. 92. A 75-year-old woman is prescribed magnesium hydroxide for constipa- tion. The nurse's assessment reveals that the patient is being treated for rheumatoid arthritis and hypertension. The patient lives in assisted living and is on a low- sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the patient's: Medication History 93. A clinic nurse has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the nurse will be to: monitor the patient's blood pressure 94. A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following?: The amount of grapefruit or orange juice she has during the day 95. A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indi- cates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is: intranasal 96. An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for: falls 97. A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regu- larly assessing the patient s heart rate, the nurse should prioritize assessment of the patient's: blood pressure 98. A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial as- sessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient: has a high coffee intake.