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The nurse is teaching a patient about taking warfarin and asks if the patient takes aspirin. This assessment by the nurse reflects a knowledge of which type of drug interaction?
A Creation of unique effects
B Increased therapeutic effects
C Inhibitory effects
D Potentiative effects
A young adult postoperative patient is receiving morphine 2 to 4 mg IV every 2 hours PRN pain. The last dose was 3 mg given 2 hours ago. The patient is asleep, and the nurse notes a heart rate of 86 beats per minute and a respiratory rate of 8 breaths per minute. Which PRN medication will the nurse give this patient?
A Diphenhydramine (Benadryl) to counter morphine side effects
B Morphine 4 mg for increased pain, as indicated by tachycardia
C Naloxone (Narcan) to block the effects of the morphine
In a discussion of drug-drug interactions, which would be the best example of a beneficial inhibitory interaction?
A Naloxone (Narcan) blocking morphine sulfate’s actions
B Antacids blocking the action of tetracycline (Sumycin)
C Alcohol blocking the actions of opioids
D Cholestyramine blocking the actions of antihypertensive drugs
A patient is taking drug X and receives a new prescription for drug Y, which is listed as an inducing agent. The nurse caring for this patient understands that this patient may require _____ doses of drug _____.
A lower; X
B lower; Y
C higher; X
D higher; Y
A patient taking oral contraceptives thinks she may be pregnant. As part of this patient’s history, what will the nurse ask the patient?
A “Do you drink grapefruit juice?”
B “Do you take seizure medication?”
C “Do you take your contraception with milk?”
D “Do you use laxatives regularly?”
A child ingests a parent’s aspirin tablets, and the prescriber orders sodium bicarbonate to block the toxic effects of the aspirin. The nurse caring for this patient knows that sodium bicarbonate is effective against the aspirin because it:
A accelerates its passage through the intestine.
B alters urinary pH to enhance renal excretion.
C induces CYP isozymes to increase drug metabolism.D raises the pH of the interstitial fluid to facilitate passage out of the cells.
Which statement about food and drug interactions is true?
A Foods alter drug absorption and metabolism but not drug action.
B Medications are best absorbed on an empty stomach.
C Patient discomfort is the food and drug interaction of most concern.Some foods can inhibit CYP isozymes and alter drug metabolism
A nurse is teaching a patient about a prescription for a monoamine oxidase (MAO) inhibitor for depression. What will the nurse teach the patient to avoid while taking this drug?
A Alcoholic beverages
B Aged cheeses
C Brussels sprouts and cabbage
D Grapefruit juice
The nurse is providing multiple medications to a patient whose spouse brings him grapefruit juice every morning. The nurse should be concerned about which classes of drugs? (Select all that apply.)
A Calcium channel blockers
B Selective serotonin reuptake inhibitors
D Beta blockers
The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.)
A Binding of one or both agents is reduced.
B Plasma levels of free drug will rise.
C Plasma levels of free drug will fall.
D The increase in free drug can intensify effects.
A nurse is caring for a patient who is taking multiple medications. To help ensure that adverse drug reactions are prevented or minimized, the nurse will do which of the following? (Select all that apply.)
A Ask the patient about over-the-counter medications used.
B Contact the prescriber to request cytochrome P450 levels.
C Limit the patient’s calcium intake.
D Obtain a thorough diet history
The prescriber has ordered an antibiotic for a patient with a bacterial infection. The nurse provides patient education at discharge and instructs the patient to take the drug on an empty stomach. When should the patient take the drug? (Select all that apply.)
A 1 hour or more before a meal
B Only after an 8-hour fast
C Only after the patient has missed a meal
D At least 2 hours after a meal
A patient is given a new medication and reports nausea within an hour after taking the drug. The nurse consults the drug information manual and learns that nausea is not an expected adverse effect of this drug. When the next dose is due, what will the nurse do?
A Administer the drug and tell the patient to report further nausea.
B Hold the drug and notify the provider of the patient’s symptoms.
C Report the symptoms of nausea to the MEDWATCH program.
A patient is being discharged after surgery. During the admission history, the nurse had learned that the patient normally consumes two or three glasses of wine each day. The prescriber has ordered hydrocodone with acetaminophen (Lortab) for pain. What will the nurse do?
A Request an order for acetaminophen without hydrocodone for pain.
B Suggest that the patient use ibuprofen for pain.
C Tell the patient not to drink wine while taking the Lortab.
D Tell the patient to limit his wine intake to one or two glasses per day.
A nurse is reviewing a medication administration record before administering medications. Which order should the nurse implement?
A Furosemide (Lasix) 20 mg QD PO
B Furosemide (Lasix) 20 mg qd PO
C Furosemide (Lasix) 20 mg dailyD. Furosemide (Lasix) 20 mg PO daily
A patient is given a drug for the first time and develops shortness of breath. The patient’s heart rate is 76 beats per minute, the respiratory rate is 20 breaths per minute, and the blood pressure is 120/70 mm Hg. The nurse checks a drug administration manual to make sure the correct dose was given and learns that some patients taking the drug experience shortness of breath. The nurse will contact the provider to report a(n):
A allergic reaction.
B idiosyncratic effect.
C iatrogenic response.
D side effect.
A nurse is preparing to give an antibiotic to a patient who reports being allergic to antibiotics. Before giving the medication, it is important for the nurse to do what?
A Ask whether the patient has taken this antibiotic for other infections.
B Question the patient about allergies to other medications.
C Obtain a history of other reactions to other drugs.
A nurse is preparing to administer a drug. Upon reading the medication guide, the nurse notes that the drug has been linked to symptoms of Parkinson’s disease in some patients. What will the nurse do?
A Ask the patient to report these symptoms, which are known to be teratogenic effects.
B Observe the patient closely for such symptoms and prepare to treat them if needed.
C Request an order to evaluate the patient’s genetic predisposition to this effect.
A nurse provides teaching to a patient who will begin taking a drug with a known risk of hepatotoxicity. Which statement by the patient indicates a need for further teaching?
A “I should avoid taking acetaminophen while taking this drug.”
B“I will need periodic evaluation of aspartate aminotransferase and alanine aminotransferase levels.”
C “If I experience nausea, vomiting, or abdominal pain, I should call my provider.”D “Routine testing and early detection of problems will prevent liver failure.”
A patient is taking sertraline (Zoloft) for depression, and the provider orders azithromycin (Zithromax) to treat an infection. What will the nurse do?
A Contact the provider to discuss an alternative to azithromycin.
B Request an order for a different antidepressant medication.
C Request an order to reduce the dose of sertraline.
A patient is taking a drug that has known toxic side effects. What will the nurse do?
A Discontinue the drug at the first signs of toxicity.
B Ensure that complete blood counts are ordered periodically.
C Monitor the function of all organs potentially affected by the drug.Teach the patient how to treat the symptoms if they develop
A nursing student is preparing to give a medication that has a black box warning. The student asks the nurse what this means. What will the nurse explain about black box warnings?
A They indicate that a drug should not be given except in life-threatening circumstances.
B They provide detailed information about the adverse effects of the drug.
C They alert prescribers to ways to mitigate potential harm from side effects.
Which actions occur in 90% of fatal medication errors? (Select all that apply.)
A Confusing drugs with similar packaging
B Giving a drug intravenously instead of intramuscularly
C Giving Nasarel instead of Nizoral
D Using an infusion device that malfunctions
E Writing a prescription illegibly
Which are effective ways to help prevent medication errors? (Select all that apply.)
A Developing nonpunitive approaches to track errors
B Focusing on caregivers who make errors
C Helping patients to be active, informed members of the healthcare team
D Naming, blaming, and shaming those who make errors
E Using electronic medical order entry systems
A postoperative patient who is worried about pain control will be discharged several days after surgery. The nurse providing discharge teaching tells the patient that the prescribed Lortab is not as strong as the morphine the patient was given in the immediate postoperative period. Which response is the patient likely to experience?
A A decreased likelihood of filling the prescription for the drug
B A negative placebo effect when taking the medication
C An increased compliance with the drug regimen
A nurse administers the same medication in the same preparation in the same dose to several patients and notes that some patients have a better response to the drug than others. What is the most likely explanation for this phenomenon?
A Altered bioavailability of the drug
B Patient compliance with the therapeutic regimen
C Pharmacogenomic differences among individuals
D Placebo effects enhancing expectations of drug efficacy
The U.S. Food and Drug Administration (FDA) recommends genetic testing of patients receiving certain medications. Genetic testing helps prescribers:
A better establish a drug’s therapeutic index.
B determine whether a patient is a rapid or slow metabolizer of the drug.
C identify racial characteristics that affect psychosocial variation in drug response.
D produce a drug that is tailored to an individual patient’s genetic makeup.
A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient’s:
A drug receptor sites.
B hypersensitivity potential.
C metabolism of drugs.
D psychosocial response.
A nurse is preparing to care for a patient who is receiving digoxin. To help minimize the potential for adverse effects from this drug, the nurse will review which of this patient’s laboratory results?
B Blood urea nitrogen (BUN) and creatinine
C Hepatic enzymesD Serum electrolytes
A patient has been taking narcotic analgesics for chronic pain for several months. The nurse caring for this patient notes that the prescribed dose is higher than the recommended dose. The patient has normal vital signs, is awake and alert, and reports mild pain. What does the nurse recognize about this patient?
A This patient exhibits a negative placebo effect with a reduced response to the drug.
B This patient has developed a reaction known as tachyphylaxis because of repeated exposure to the drug.This patient has developed pharmacodynamic tolerance, which has increased the minimal effective concentration (MEC) needed for analgesic effect
A nurse is caring for a woman with breast cancer who is receiving tamoxifen. A review of this patient’s chart reveals a deficiency of the CYP2D6 gene. The nurse will contact the provider to suggest:
A a different medication.
B an increased dose.
C a reduced dose.
D serum drug levels.
A nurse is teaching a group of women about medications. The women want to know why so many drugs have unpredictable effects in women. The nurse will tell them that:
A drugs usually have more toxic effects in women.
B most known drug effects are based on drug trials in men.
C women have varying responses to drugs during menstrual cycles.
Which groups of people are especially sensitive to medication effects? (Select all that apply.)
A Older adults
A nurse is caring for a patient and her newborn immediately after delivery. The patient’s medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What will the nurse expect to do?
A Administer opioids to the infant to prevent withdrawal syndrome.
B Monitor the infant’s respirations closely and prepare to administer oxygen.C Note a high-pitched cry and irritability in the infant
A patient who has just learned she is pregnant has stopped using a prescription medication that she takes for asthma because she doesn’t want to harm her baby. What will the nurse tell her?
A That asthma medications will not affect the fetus
B That her baby’s health is dependent on hers
C To avoid taking medications during her pregnancy
D To resume the medication in her second trimester
A nurse is teaching a class to a group of pregnant patients. The nurse correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time?
A Immediately before conception
B During the first trimester
C During the second trimester
D During the third trimester
A pregnant patient in active labor is admitted to the emergency department. A toxicology screen and a physical assessment reveal that the patient is an active heroin addict. The nurse who cares for the neonate after delivery should anticipate which clinical manifestation(s)?
A Passivity and flat affect
B Diarrhea and salivation
C A shrill cry and irritabilityD Continuous restless sleep
A patient has just given birth to a baby boy with a cleft palate. The nurse will review the patient’s medication history with special emphasis on drugs taken during which period?
A Before she became pregnant
B During the first trimester
C During the second trimester
D During the third trimester
A pregnant patient asks the nurse about the safe use of medications during the third trimester. What will the nurse tell her about drugs taken at this stage?
A They may need to be given in higher doses if they undergo renal clearance.
B They require lower doses if they are metabolized by the liver.
C They are less likely to cross the placenta and affect the fetus.
A breast-feeding patient must take a prescription medication for 2 weeks. The medication is safe, but the patient wants to make sure her baby receives as little of the drug as possible. What will the nurse tell the patient?
A To give the baby formula as long as the mother is taking the medication
B To take the medication immediately after breast-feeding
C To pump breast milk and feed the baby by bottle
Which type of drug taken by a pregnant patient is more likely to have effects on a fetus?
A Drug that is highly polar
B Ionized drug
C Lipid-soluble drug
D Protein-bound drug
A patient in her second trimester of pregnancy tells the nurse she is worried that a medication she took before knowing she was pregnant might have harmed the fetus. What will the nurse do?
A Ask the patient what she took and when she learned she was pregnant.
B Contact the patient’s provider to request an ultrasound.
C Counsel the patient to consider termination of the pregnancy.
D Suggest to the patient that she go to a high-risk pregnancy center.
An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant’s parents ask the nurse about using a topical antihistamine. What does the nurse tell them?
A Antihistamines given by this route are not absorbed as well in children.
B Applying this medication to the skin can cause toxicity in this age group.
C The child will also need oral medication to achieve effective results.
A pediatric nurse is teaching nursing students about medication administration in children. Which statement by a student indicates an understanding of the teaching?
A “Drugs effective in adults may not work in children, even if the dose is proportional for weight and size.”
B “Infants metabolize drugs more quickly than do older children and adults.”
C “Side effects of drugs in children are similar to side effects of drugs in adults.”
The parents of a child with asthma ask the nurse why their child cannot use oral corticosteroids more often, because they are so effective. The nurse will offer which information that is true for children?
A Chronic steroid use can inhibit growth.
B Frequent use of this drug may lead to a decreased response.
C A hypersensitivity reaction to this drug may occur.
D Systemic steroids can be toxic.
Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not recommended for infants. Which response by the nurse is correct?
A “Babies have a more rapid gastric emptying time and don’t absorb drugs well.”
B “Cough medicine tastes bad, and infants usually won’t take it.”
C “Infants are more susceptible to central nervous system effects than are adults.”
A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant’s age and weight, the nurse administers a narcotic analgesic intravenously. When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths per minute and a heart rate of 110 beats per minute. The infant is asleep in the parent’s arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the result of:
A an allergic reaction to the medication.
B immaturity of the blood-brain barrier in the infant.
C toxic effects of the narcotic, requiring naloxone (Narcan) as an antidote.
An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving the medication, the nurse will assess the infant for:
A decreased effectiveness of the drug.
B shorter period of the drug’s effects.
C signs of drug toxicity.
D unusual CNS effects.
A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to:
A order a dose that is lower than an adult dose.
B order a dose that is higher than an adult dose.
C increase the frequency of medication dosing.discontinue the drug after one or two doses
A pediatric nurse is teaching nursing students to calculate medication doses for children using a formula based on body surface area. Which statement by a nursing student indicates understanding of the teaching?
A “The formula helps approximate the first dose; other doses should be based on clinical observations.”
B “This formula accounts for pharmacokinetic factors that are different in children.”
C “Using this formula will prevent side effects of medications in children.”
A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse discuss with the child’s provider?
A 250 mg/5 mL–375 mg PO bid
B 250 mg/5 mL–250 mg PO tid
C 500 mg/5 mL–250 mg PO tid
D 500 mg/5 mL–375 mg PO bid
A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking a medication history, the nurse will ask about which group of medications?
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