Quiz 2- questions and answers PDF

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Quiz 2- questions and answers...

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Pharm Quiz #2 Multiple Choice Identify the choice that best completes the statement or answers the question. ____

1. A patient is recovering from abdominal surgery, which he had this morning. He is groggy but

complaining of severe pain around his incision. What is the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient? a. His pulse rate b. His respiratory rate c. The appearance of the incision d. The date of his last bowel movement ____

2. A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after

abdominal surgery. The nurse will include which information in the teaching plan? How to prevent dehydration due to diarrhea Importance of taking the drug only when the pain becomes severe How to prevent constipation Importance of taking the drug on an empty stomach

a. b. c. d. ____

3. The nurse is assessing a patient for contraindications to drug therapy with acetaminophen (Tylenol).

Which patient should not receive acetaminophen? A patient with a fever of 101 F (38.3 C) A patient who is complaining of a mild headache A patient with a history of liver disease A patient with a history of peptic ulcer disease

a. b. c. d. ____

4. During the immediate postoperative recovery period, what is the nurse’s priority assessment? a. Pupil responses b. Return to sensation c. Level of consciousness d. Airway, breathing, and circulation

____

5. A patient has been admitted to the emergency department for an overdose of oral benzodiazepines.

He is very drowsy but still responsive, with a respiration rate of 12 breaths per minute. The nurse will prepare for which immediate intervention? a. Hemodialysis to remove the medication b. Administration of flumazenil (Romazicon) c. Administration of naloxone (Narcan) d. Intubation and mechanical ventilation ____

6. A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride

(Ritalin) for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be “in his system” when he goes to school the next morning. What is the nurse’s appropriate evaluation of the mother’s actions? a. She is giving him the medication dosage appropriately. b. The medication should not be taken until he is at school.

c. The medication should be taken with meals for optimal absorption. d. The medication should be given 4 to 6 hours before bedtime to diminish insomnia. ____

7. The nurse is teaching a patient how to self-administer triptan injections for migraine headaches.

Which statement by the patient indicates that he needs further teaching? a. “I will take this medication regularly to prevent a migraine headache from

occurring.” b. “I will take this medication when I feel a migraine headache starting.” c. “This medication does not reduce the number of migraines I will have.” d. “I will keep a journal to record the headaches I have and how the injections are

working.” ____

8. A patient has a 9-year history of a seizure disorder that has been managed well with oral phenytoin

(Dilantin) therapy. He is to be NPO (consume nothing by mouth) for surgery in the morning. What will the nurse do about his morning dose of phenytoin? a. Give the same dose intravenously. b. Give the morning dose with a small sip of water. c. Contact the prescriber for another dosage form of the medication. d. Notify the operating room that the medication has been withheld. ____

9. A patient has been taking an AED for several years as part of his treatment for partial seizures. His

wife has called because he ran out of medication this morning and wonders if he can go without it for a week until she has a chance to go to the drugstore. What is the nurse’s best response? a. “He is taking another antiepileptic drug, so he can go without the medication for a week.” b. “Stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away.” c. “He can temporarily increase the dosage of his other antiseizure medications until you get the refill.” d. “He can stop all medications because he has been treated for several years now.” ____ 10. When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment

for Parkinson’s disease, the nurse should include which information in the teaching plan? a. Minimize the amount of fluid taken while on this drug. b. Discontinue the medication if adverse effects occur. c. Take the medication on an empty stomach to enhance absorption. d. Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth.

Pharm Quiz #2 Answer Section MULTIPLE CHOICE 1. ANS: B

One of the most serious adverse effects of opioids is respiratory depression. The nurse must assess the patient’s respiratory rate before administering an opioid. The other options are incorrect. PTS: REF: MSC: 2. ANS:

1 DIF: COGNITIVE LEVEL: Applying (Application) p. 150 TOP: NURSING PROCESS: Assessment NCLEX: Physiological Integrity: Reduction of Risk Potential C

Gastrointestinal adverse effects, such as nausea, vomiting, and constipation, are the most common adverse effects associated with opioid analgesics. Physical dependence usually occurs in patients undergoing long-term treatment. Diarrhea is not an effect of opioid analgesics. Taking the dose with food may help minimize GI upset. PTS: REF: MSC: 3. ANS:

1 DIF: COGNITIVE LEVEL: Applying (Application) p. 167 TOP: NURSING PROCESS: Implementation NCLEX: Physiological Integrity: Reduction of Risk Potential C

Liver disease is a contraindication to the use of acetaminophen. Fever and mild headache are both possible indications for the medication. Having a history of peptic ulcer disease is not a contraindication. PTS: REF: MSC: 4. ANS:

1 DIF: COGNITIVE LEVEL: Applying (Application) p. 156 TOP: NURSING PROCESS: Assessment NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies D

After surgery and the termination of general anesthesia, the priority assessment is the patient’s airway, breathing, and circulation status. The other assessments are important but are not the immediate concern. PTS: REF: MSC: 5. ANS:

1 DIF: COGNITIVE LEVEL: Applying (Application) p. 180 TOP: NURSING PROCESS: Assessment NCLEX: Safe and Effective Care Environment: Management of Care B

Flumazenil (Romazicon), a benzodiazepine antidote, can be used to acutely reverse the sedative effects of benzodiazepines. Hemodialysis is not useful for benzodiazepine overdose, and naloxone is used for opioid overdose, not benzodiazepine overdose. Intubation and mechanical ventilation are not appropriate because the patient is still responsive and breathing on his own. PTS: REF: MSC: 6. ANS:

1 DIF: COGNITIVE LEVEL: Applying (Application) p. 191 TOP: NURSING PROCESS: Implementation NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies D

Central nervous system stimulants should be taken 4 to 6 hours before bedtime to decrease insomnia. Generally speaking, once-a-day dosing is used with extended-release or long-acting preparations. These formulations eliminate the need to take this medication at school. PTS: REF: MSC: 7. ANS:

1 DIF: COGNITIVE LEVEL: Applying (Application) p. 215 TOP: NURSING PROCESS: Evaluation NCLEX: Physiological Integrity: Physiological Adaptation A

Although they may be taken during aura symptoms by patients who have auras with their headaches, these drugs are not indicated for preventive migraine therapy. The medication is intended to relieve the migraine and not to prevent it or to reduce the number of attacks. The triptans do not reduce the number of migraines a person will have. Journal recordings of headaches and the patient’s responses to the medication are helpful. PTS: REF: MSC: 8. ANS:

1 DIF: COGNITIVE LEVEL: Applying (Application) p. 209 TOP: NURSING PROCESS: Implementation NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies C

If there are any questions about the medication order or the medication prescribed, contact the prescriber immediately for clarification and for an order of the appropriate dose form of the medication. Do not change the route without the prescriber’s order. Withholding the medication may lead to seizure activity during the surgical procedure. PTS: REF: MSC: 9. ANS:

1 DIF: COGNITIVE LEVEL: Applying (Application) p. 234 TOP: NURSING PROCESS: Implementation NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies B

Abrupt discontinuation of antiepileptic drugs can lead to withdrawal seizures. The other options are incorrect. The nurse cannot change the dose or stop the medication without a prescriber’s order. PTS: REF: MSC: 10. ANS:

1 DIF: COGNITIVE LEVEL: Applying (Application) p. 221 TOP: NURSING PROCESS: Implementation NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies D

Dry mouth can be managed with artificial saliva through drops or gum, frequent mouth care, forced fluids, and sucking on sugar-free hard candy. Anticholinergics should be taken with or after meals to minimize gastrointestinal upset and must not be discontinued suddenly. The patient must drink at least 3000 mL per day unless contraindicated. Drinking water is important, even if the patient is not thirsty or in need of hydration, to prevent and manage the adverse effect of constipation. PTS: 1 DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 249 TOP: NURSING PROCESS: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies...