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NUR 2474 / NUR2474 Final Exam: Pharmacology for Professional Nursing Final Exam Review (Latest 2021/2022) Rasmussen

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NUR 2474 Pharmacology Final Exam NCLEX The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess ... first? a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin b.The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin) c.The patient with a blood pressure of 136/92 mm Hg who complains of having a headache d.The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a.No insulin should be administered. b.NPH c.70/30 mix d.Lispro (Humalog) d.Lispro (Humalog) A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule? a.Before each meal and before bed b.In the morning for a fasting level and at 4 PM for the peak level c.Six or seven times a day d.Three times a day, along with urine glucose testing c.Six or seven times a day An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response? a."Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." b."At this level, you probably have diabetes. You will need an oral glucose tolerance test this week." c."This level is conclusive evidence that you have diabetes." d."This level is conclusive evidence that you do not have diabetes." a."Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug? a.Approximately 15 to 30 minutes before each meal b.In the morning and at 4 PM c.Once daily at bedtime d.After meals and at bedtime c.Once daily at bedtime A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? a.The beta blocker can cause insulin resistance. b.Using the two agents together increases the risk of ketoacidosis. c.Propranolol increases insulin requirements because of receptor blocking. d.The beta blocker can mask the symptoms of hypoglycemia. d.The beta blocker can mask the symptoms of hypoglycemia. Which statement is correct about the contrast between acarbose and miglitol? a.Miglitol has not been associated with hepatic dysfunction. b.With miglitol, sucrose can be used to treat hypoglycemia. c.Miglitol is less effective in African Americans. d.Miglitol has no gastrointestinal side effects. a.Miglitol has not been associated with hepatic dysfunction. A nurse counsels a patient with diabetes who is starting therapy with an alpha-glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.) a.Hypoglycemia b.Flatulence c.Elevated iron levels in the blood d.Fluid retention e.Diarrhea b.Flatulence e.Diarrhea The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? a.Hypothyroidism is a normal effect of pregnancy and usually is of no consequence. b.Neuropsychologic deficits in the fetus can occur if the condition is not treated. c.No danger to the fetus exists until the third trimester. d.Treatment is required only if the patient is experiencing symptoms. b.Neuropsychologic deficits in the fetus can occur if the condition is not treated. A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching? a."I should not take heartburn medication without consulting my provider." b."I should report insomnia, tremors, and an increased heart rate to my provider." c."If I take a multivitamin with iron, I should take it 4 hours after the Synthroid." d."If I take calcium supplements, I may need to decrease my dose of Synthroid." d."If I take calcium supplements, I may need to decrease my dose of Synthroid." A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug? a.Beta blocker b.Increased dose of PO levothyroxine c.Intravenous levothyroxine d.Methimazole (Tapazole) c.Intravenous levothyroxine A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The nurse will notify the provider to discuss _____ the _____ dose. a.reducing levothyroxine b.reducing warfarin c.increasing levothyroxine d.increasing warfarin b.reducing; warfarin An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine (Levothroid) 100 mcg/day PO. What will the nurse do? a.Administer the medication as ordered. b.Contact the provider to discuss giving the levothyroxine IV. c.Request an order to give desiccated thyroid (Armour Thyroid). d.Suggest that the provider lower the dose. d.Suggest that the provider lower the dose. A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine (Synthroid). The child comes to the clinic for a well-child check up. The nurse will expect the provider to: a.change the dose of levothyroxine to 6 mcg/kg/day. b.discontinue the drug if the child's physical and mental development is normal. c.increase the dose to accommodate the child's increased growth. d.stop the drug for 4 weeks and check the child's TSH level. a.change the dose of levothyroxine to 6 mcg/kg/day. A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action? a.Apply warm packs to the arm, and infuse the medication at a slower rate. b.Continue the infusion while elevating the arm. c.Select an alternate intravenous site and administer the infusion more slowly. d.Request central venous access. c.Select an alternate intravenous site and administer the infusion more slowly. A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? a."Cephalosporins are assigned to generations based on their relative costs to administer." b."Cephalosporins have increased activity against gram-negative bacteria with each generation." c."First-generation cephalosporins have better penetration of the cerebrospinal fluid." d."Later generations of cephalosporins have lower resistance to destruction by beta-lactamases." b."Cephalosporins have increased activity against gram-negative bacteria with each generation." A provider has ordered ceftriaxone 4 gm once daily for a patient with renal impairment. What will the nurse do? a.Administer the medication as prescribed. b.Contact the provider to ask about giving the drug in divided doses. c.Discuss increasing the interval between doses with the provider. d.Discuss reducing the dose with the provider. a.Administer the medication as prescribed. A patient will be discharged home to complete treatment with intravenous cefotetan with the assistance of a home nurse. The home care nurse will include which instruction when teaching the patient about this drug treatment? a.Abstain from alcohol consumption during therapy. b.Avoid dairy products while taking this drug. c.Take an antihistamine if a rash occurs. d.Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain. a.Abstain from alcohol consumption during therapy. The nurse is caring for a patient who is receiving vancomycin (Vancocin). The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: a.allergic reaction. b.red man syndrome. c.rhabdomyolysis. d.Stevens-Johnson syndrome. b.red man syndrome. A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. The nurse expects the provider to order which cephalosporin? a.First-generation cephalosporin b.Second-generation cephalosporin c.Third-generation cephalosporin d.Fourth-generation cephalosporin a.First-generation cephalosporin A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What is an appropriate treatment for this patient? a.Adding an antibiotic, such as vancomycin (Vancocin), to the patient's regimen b.Discontinuing the cephalosporin and beginning metronidazole (Flagyl) c.Discontinuing all antibiotics and providing fluid replacement d.Increasing the dose of the cephalosporin and providing isolation measures b.Discontinuing the cephalosporin and beginning metronidazole (Flagyl) Besides the cost of administering a given drug, which are considerations when a provider selects a cephalosporin to treat an infection? (Select all that apply.) a.Adverse effects b.Antimicrobial spectrum c.Brand name d.Manufacturer e.Pharmacokinetics a.Adverse effects b.Antimicrobial spectrum e.Pharmacokinetics A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do? a.Make sure to administer the drugs at different times using different IV tubing. b.Suggest giving larger doses of piperacillin and discontinuing the amikacin. c.Suggest that a fixed-dose combination of piperacillin and tazobactam (Zosyn) be used. d.Watch the patient closely for allergic reactions, because this risk is increased with this combination. a.Make sure to administer the drugs at different times using different IV tubing. A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: a.disinhibit transpeptidases. b.disrupt bacterial cell wall synthesis. c.inhibit autolysins. d.inhibit host cell wall function. b.disrupt bacterial cell wall synthesis. A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history, the nurse learns that the patient experienced a rash when given amoxicillin (Amoxil) as a child 20 years earlier. What will the nurse do? a.Ask the provider to order a cephalosporin. b.Reassure the patient that allergic responses diminish over time. c.Request an order for a skin test to assess the current risk. d.Suggest using a desensitization schedule to administer the drug. c.Request an order for a skin test to assess the current risk. A patient with no known drug allergies is receiving amoxicillin (Amoxil) PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? a.Contact the provider and prepare to administer epinephrine. b.Notify the provider if the patient develops a rash. c.Request an order for a skin test to evaluate possible PCN allergy. d.Withhold the next dose until symptoms subside. a.Contact the provider and prepare to administer epinephrine. A patient with an infection caused by Pseudomonas aeruginosa is being treated with piperacillin. The nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss: a.adding an aminoglycoside. b.changing to penicillin G. c.reducing the dose of piperacillin. d.ordering nafcillin. c.reducing the dose of piperacillin. A patient recently began receiving clindamycin (Cleocin) to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient? a.The provider may increase the clindamycin dose to treat this infection. b.This is a known side effect of clindamycin, and the patient should consume extra fluids. c.The patient should stop taking the clindamycin now and contact the provider immediately. d.The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms. c.The patient should stop taking the clindamycin now and contact the provider immediately. Which side effect of clindamycin (Cleocin) causes the most concern and may warrant discontinuation of the drug? a.Diarrhea b.Headache c.Nausea d.Vomiting a.Diarrhea A patient develops CDAD. Which antibiotic is recommended for treating this infection? a.Chloramphenicol b.Clindamycin (Cleocin) c.Linezolid (Zyvox) d.Vancomycin d.Vancomycin A pregnant patient is treated with trimethoprim/sulfamethoxazole (TMP/SMZ) (Bactrim) for a urinary tract infection at 34 weeks' gestation. A week later, the woman delivers her infant prematurely. The nurse will expect to monitor the infant for: a.birth defects. b.hypoglycemia. c.rash. d.scleral jaundice. d.scleral jaundice. A patient who is taking immunosuppressants develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct? a."Immunosuppressed patients are folate deficient." b."Patients who are immunosuppressed are more likely to develop resistance." c."Sulfonamides are bacteriostatic and depend on host immunity to work." d."Sulfonamides intensify the effects of immunosuppression." c."Sulfonamides are bacteriostatic and depend on host immunity to work." A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching? a."I need to drink extra fluids while taking this medication." b."I need to use sunscreen when taking this drug." c."I should call my provider if I develop a rash while taking this drug." d."I should stop taking this drug when my symptoms are gone." d."I should stop taking this drug when my symptoms are gone." A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection, and the prescriber orders TMP/SMZ. What will the nurse tell the patient? a.Patients with diabetes have an increased risk of an allergic reaction. b.Patients taking TMP/SMZ may need increased doses of glipizide. c.The patient should check the blood glucose level more often while taking TMP/SMZ. d.The patient should stop taking the glipizide while taking the TMP/SMZ. c.The patient should check the blood glucose level more often while taking TMP/SMZ. A nurse is obtaining a drug history from a patient about to receive sulfadiazine. The nurse learns that the patient takes warfarin, glipizide, and a thiazide diuretic. Based on this assessment, the nurse will expect the provider to: a.change the antibiotic to TMP/SMZ. b.increase the dose of the glipizide. c.monitor the patient's electrolytes closely. d.monitor the patient's coagulation levels. d.monitor the patient's coagulation levels. A patient will be discharged from the hospital with a prescription for TMP/SMZ (Bactrim). When providing teaching for this patient, the nurse will tell the patient that it will be important to: a.drink 8 to 10 glasses of water each day. b.eat foods that are high in potassium. c.take the medication with food. d.take folic acid supplements. a.drink 8 to 10 glasses of water each day. A nurse is discussing microbial resistance among sulfonamides and trimethoprim with a nursing student. Which statement by the student indicates a need for further teaching? a."Bacterial resistance to trimethoprim is relatively uncommon." b."Resistance among gonococci, streptococci, and meningococci to sulfonamides is high." c."Resistance to both agents can occur by spontaneous mutation of organisms." d."Resistance to sulfonamides is less than resistance to trimethoprim." d."Resistance to sulfonamides is less than resistance to trimethoprim." A patient with bronchitis is taking TMP/SMZ, 106/80 mg orally, twice daily. Before administering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103° F, and a heart rate of 100 beats per minute. The patient looks ill and reports not feeling well. What will the nurse do? a.Administer the dose and request an order for an antipyretic medication. b.Withhold the dose and request an order for an antihistamine to treat the rash. c.Withhold the dose and notify the provider of the symptoms. d.Request an order for intravenous TMP/SMZ, because the patient is getting worse. c.Withhold the dose and notify the provider of the symptoms. A patient with histoplasmosis is being treated with itraconazole (Sporanox). The nurse will teach this patient to report which symptoms? a.Gynecomastia and decreased libido b.Headache and rash c.Nausea, vomiting, and anorexia d.Visual disturbances c.Nausea, vomiting, and anorexia A patient who is pregnant has a history of recurrent genital herpesvirus (HSV). The patient asks the nurse what will be done to suppress an outbreak when she is near term. The nurse will tell the patient that: a.antiviral medications are not safe during pregnancy. b.intravenous antiviral agents will be used if an outbreak occurs. c.oral acyclovir (Zovirax) may be used during pregnancy. d.topical acyclovir (Zovirax) must be used to control outbreaks c.oral acyclovir (Zovirax) may be used during pregnancy. [Show More]

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