NURS6521 Advanced Pharmacology
Midterm Exam
Which of the following patients demonstrates the clearest indication for treatment with prednisone?
- A 66-year-old woman whose history of smoking has culminated in a
- A 70-year-old man whose rheumatoid arthritis has not responded to OTC
- A 12-year-old boy whose long-standing fatigue and malaise have been
- A 50-year-old woman who is being treated for hypertension with a
diagnosis of emphysema
pain relievers
attributed to leukemia
diuretic and an ACE inhibitor
Correct Answer:
- A 70-year-old man whose rheumatoid arthritis has not responded to OTC
pain relievers Prednisone is mostly used to treat conditions such as breathing problems, skin diseases, arthritis, immune system disorders, eye problems, blood problems and disorders, allergies, and cancer. Prednisone lowers the response of the immune system of an individual to various diseases with an aim of reducing some symptoms such as allergic reactions and swellings. Prednisone achieves this as it belongs to a category of drugs referred to as corticosteroids. Emphysema, leukemia, and hypertension do not need lowering of the response of the body's immune system and hence cannot be treated using prednisone.
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A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to__
- passive diffusion.
- active transport.
- glomerular filtration.
- first-pass effect
Correct Answer:
- First pass effect is a phenomenon of drug metabolism whereby the
concentration of a drug specifically when administered orally, is greatly reduced before it reaches the systemic circulation. Therefore, necessitating the need for higher oral dosage than the parenteral dose.
A nurse is caring for a postsurgical patient who has small torturous veins and had a difficult IV insertion. the patient is now receiving medications on a regular basis. what is the best nursing intervention to minimize the adverse effects of this drug therapy?
- monitor the patient's bleeding time
- check the patients blood glucose levels
- record baseline vital signs
- Monitor the IV site for redness, swelling, or pain
Correct Answer:
- monitor the iv site for redness, swelling, or pain
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A patient is in the clinic after 6 weeks of taking riluzozle (Rilutek) for a recent diagnosis of amyotrophic lateral sclerosis. The nurse will prioritize assessment for which of the following?
- weight gain
- constipation
- increased energy
- dizziness
Correct Answer:
- dizziness
A cardiac care nurse is monitoring a patient who is receiving lidocaine (Xylocaine) per IV infusion pump for an acute ventricular arrhythmia associated with an acute MI. Which of the following patient manifestations would cause the nurse to notify the physician immediately?
- Confusion
- Headache
- Nausea
- Leg cramps
Correct Answer:
- The nurse would notify the physician immediately if the patient exhibits
confusion while receiving lidocaine (Xylocaine) for an acute ventricular arrhythmia associated with an acute MI. Confusion can be a sign of lidocaine toxicity, which can lead to serious complications such as seizures or cardiac arrest. Therefore, it is important to alert the physician promptly so that appropriate interventions can be taken to ensure the patient's safety and well-being.
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A nurse is caring for a patient who is admitted into the cardiac care unit with acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered.When preparing for administration of the drug, the nurse will__
- add the reconstituted vial of medication to a 1,000 mL IV bag.
- shake the vial vigorously to mix the medication for reconstitution.
- administer the initial IV bolus over approximately 60 seconds.
- use the reconstituted solution within a 36-hour period
Correct Answer:
- Nesiritide is used for intravenous treatment of individuals with acutely
decompensated heart failure who have dyspnea (shortness of breath) at rest or with minimal activity. Following the preparation of the infusion bag, withdraw the bolus volume from the Nesiritide infusion bag and administer it over approximately 60 seconds through an IV port in the tubing. Blood pressure must be monitored closely during Nesiritide administration.
A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately?
- Increased urination
- Muscle twitching
- Hair loss
- Increased thirst
Correct Answer:
- Muscle twitching
Explanation: Muscle twitching can be a sign of lithium toxicity and should be
reported immediately. Increased urination, hair loss, and increased thirst are common side effects of lithium therapy but do not require immediate reporting unless they become severe or persistent.
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