Adverse Effects of Medications: A Nursing Perspective, Exams of Pharmacology

Download Adverse Effects of Medications: A Nursing Perspective and more Exams Pharmacology in PDF only on Docsity! NURS 407 PHARMACOLOGY 2 EXAM QUESTIONS WITH CORRECT ANSWERS 1. A nurse is caring for a client who reports using the herbal medication garlic along with prescribed warfarin. The nurse should identify that which of the following is a potential adverse effect of taking both of these products concurrently? • Altered renal perfusion • Elevated blood pressure • Increased ecchymosis- The nurse should identify that ecchymosis occurs when there is bleeding under the skin. Additionally, the nurse should recognize that, garlic has antiplatelets effects that can result in bleeding. When taken concurrently with an anticoagulant, such as warfarin, there is an increased risk for bleeding. 2. A nurse is providing teaching t a client who is starting to take aspirin. The nurse should instruct the client to monitor for which of the following findings as an adverse effect of this medication? • Black, tarry stools- A client who takes aspirin can have an increased risk for bleeding because aspirin suppresses platelet aggregation. The nurse should instruct the client to monitor for and report indications of bleeding, such as bruising, petechiae, and blood in stools or urine. • Nystagmus • Dry mouth 3. A nurse is caring for a client who has an infection and is starting to take gentamicin. Which of the following client laboratory tests should the nurse monitor to detect an adverse effect of the medication? • B-type natriuretic peptide (BNP) • Creatinine - The nurse should monitor creatinine, BUN and urine output for a client who is receiving gentamicin, and aminoglycoside antibiotic. Gentamicin is an aminoglycoside that has both nephrotoxic and ototoxic adverse effects. • Amylase level 4. A nurse is assessing a client who has diabetes insipidus and is starting intranasal desmopressin. Which of the following findings should indicate to the nurse that medication is effective? • The client has clear mucus • The client’s 24 hr urine output is 1.256 mL - Desmopressin is effective for the treatment of diabetes insipidus, a disorder of the posterior pituitary gland in which large amount of dilute urine are produced due to a deficiency in vasopressin. The action of desmopressin causes reabsorption of water and a decrease in urine volume. A urine output of 1.256 mL over 24 hr is within the expected reference range and indicates the medication is effective. 5. A nurse is assessing a client who has a prescription for haloperidol 0.5 mg PO three times daily. The medication administration record shows that the client received 5 mg per dose on the previous day. Which of the following manifestations is the nurse’s priority to assess? • Muscle stiffness - The nurse should recognize tha the greatest risk to the client is developing neuroleptic malignant syndrome, and adverse reaction to haloperidol that is potentially fatal if not treated promptly. Manifestations of neuroleptic malignant 1 syndrome include extreme muscle stiffness, sudden increase in temperature, diaphoresis, dysrhythmias, and fluctuations in blood pressure. • Blurred vision • Constipation 6. A nurse is assessing a client who received ondansetron 1 hr. ago. Which of the following findigns should the nurse identify as a therapeutic effect of the medication? • Decreased pain • Suppressed emesis – Ondansetron suppresses nausea and vomiting induced by chemotherapy, anesthesia, radiation therapy, or morning sickness by blocking serotonin receptors in the upper GI tract and in the CNS • Supresed cough • Decreased fever 7. A nurse is caring for a client who is receiving morphine. Which of the following assessments should the nurse perform first? • Apical heart rate • Blood pressure • Respiratory rate – When using the airway, breathing, circulation approach to client care, the nurse should determine that the priority assessment is respiratory rate. The nurse should withhold the morphine and notify the provider if the respiratory rate is less than 12/min. 8. A nurse is caring for a client who is at risk for alcohol withdrawal delirium. Which of the following medications should the nurse expect the provider to prescribe? • Naloxone • Bupropion • Methadone • Chlordiazepoxide – The nurse should expect the provider to prescribe chlordiazepoxide, a benzodiazepine, to a client who is at risk for alcohol withdrawal delirium. Chlordiazepoxide can prevent the client form experiencing seizures as a result of withdrawal and lessen the effects of withdrawal. 9. A nurse is teaching a client who is to start taking methyldopa for the treatment of hypertension. Which of the following information should the nurse include in the teaching? • The medication can cause dizziness- Methyldopa can cause orthostatic hypotension and dizziness when the client is changing position. Therefore, the nurse should instruct the client to change position slowly while taking methyldopa. • This medication can cause insomnia • Expect to experience depression while taking this medication 10. A nurse is providing discharge instructions to a client who has a new prescription for omeprazole for the treatment of GERD. Which of the following statements by the client indicates an understanding of the teaching? • This medication kiss the bacteria in my stomach. • This medication neutralizes stomach acid • This medication coats the lining of my stomach. • This medication reduces stomach acid – GERD is a condition in which gastric acids reflux from the stomach to the esophagus. Omeprazole is a proton inhibitor that suppresses the production of gastric acid. The medication reduces baseline acid levels 2 manifestation of lidocaine toxicity. Therefore lidocaine and has a decreased respiratory rate is unstable and this finding is the highest priority to report to the provider. 21. A nurse is reviewing the medical history of a client who has myasthenia gravis and is asking about starting neostigmine. The nurse should identify which of the following client conditions as a potential contraindication for cholinesterase inhibitor therapy? • Cataracts • Hypertension • Hypothyroidism • Peptic ulcer disease—Neostigmine, a cholinesterase inhibitor, increases gastric secretions which would further exacerbate the peptic ulcer disease, thereby increasing the risk for erosion and perforation. 22. A nurse is providing teaching to a client who has angina and a new prescription for sublingual nitroglycerin tablet. Which of the following instructions should the nurse include in the teaching? • Repeat up to four doses until pain is relieved. • Store unused tablets at room temperature – The client should not expose tablets to moisture, heat, or air, and should replace the tablets 6 months after they are opened to retain potency. 23. A nurse is providing teaching to a client who has a duodenal ulcer and is starting to take sucralfate. Which of the following instructions should the nurse include in the teaching? • Take this medication with meals • Reduce dietary fiber while taking the medication • Administer an antacid with the medication • Increase fluid intake while taking the medication—The nurse should instruct the client to increase their fluid and dietary fiber intake to prevent constipation, a potential adverse effect of sucralfate. 24. A nurse is assessing a client who started taking furosemide 2 days ago and ahs a potassium level of 3.1 mEq/L. Which of the following findings should the nurse expect? • Muscle rigidity of the extremities • Bounding radial pulses • Depressed deep tendon reflexes—A potassium level of 3.1 mEq/L is lower thatn the expected reference range of 3.5 to 5 mEq/L and is an indication of hypokalemia. The nurse should expect depressed deep tendon reflexes in a client who has hypokalemia • Increased bowel motility 25. A nurse is administering bumetanide to a client who has ascites. The nurse should recognize that which of the following findings is an expected therapeutic effect of this medication? • Decreased excretion of urine sodium • Increased urinary output-- The primary action of bumetanide , a loop diuretic, is to increase the excretion of water and electrolytes through the urine. Bumetanide decreases edema associated with heart failure, liver disease, or renal compromise by increasing urinary output. • Decreased serum glucose 5 28. A nurse is teaching a client who has a new prescription for benzonatate. Which of the following statements by the client indicates an understanding of the teaching? • I should not drive while taking this medication --- adverse effects of benzonatate can include sedation and dizziness. • This medication will help me cough up the mucus in my chest • I should decrease my dietary fiber intake while taking this medication 29. A nurse is teaching a client who has a new prescription for isoniazid to treat tuberculosis. Which of the following information should the nurse include in the teaching? • You will have frequent sputum tests to monitor the effectiveness of this medication – sputum specimen every 2 to 4 weeks to monitor the effectiveness of this medication. The client is no longer infectious following three consecutives negative sputum cultures. However, the client should continue the antibiotic treatment for 6 to 112 months. • You will be able to stop taking this medication after 1 month • You can take an antacid containing aluminum at the same time as this medication 30. A nurse is reviewing the health history of a client who experience migraine headaches and has asked about a prescription for sumatriptan. Which of the following condition should the nurse identify as a contraindication for taking sumatriptan? • Asthma • Kidney disease • Rheumatoid arthritis • Coronary artery disease – Client who has history or risk of coronary artery disease should not take sumatriptan. The mediation can cause coronary vasospasm, ECG changes, and hypertension. 31. A nurse is caring for a client who has chemotherapy- induced anemia. Thea nurse should expect to administer which of the following medications to treat the anemia? • Sargramostim • Filgrastim • Epoetin – This medication stimulates red blood cell production and can reduce the need for periodic blood transfusions. • Romiplostim 32. A nurse is teaching a client who has a seizure disorder and has a new prescription for phenytoin. Which of the following client statements indicates an understanding of the teaching? • I will expect to have dark urine while taking this medication • I will take an extra dose of the medication if I have a breakthrough seizure • I will have my blood checked to monitor the medication levels – The client should have serum phenytoin level tested to maintain therapeutic blood levels and prevent toxicity. Therapeutic phenytoin levels range from 10 to 20 mcg/mL. Once a safe and therapeutic dosage level is established, the client should continue to adhere to prescribed dosage schedule and continue routine monitoring. 33. A nurse is monitoring a client who is receiving a continuous IV infusion of dopamine. Which of the following findings requires immediate intervention by the nurse? • Hear rate 105/min • Increased blood pressure 6