Download NURS 180 Pharmacology Final Exam | West Coast University | 2025–2026 | Verified Questions and more Exams Pharmacology in PDF only on Docsity!
NURS 180 pharm Final WCU Latest Version
2025 - 2026| Questions and Correct Answers
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what needs to be taken with psyllium and how much? 8 oz of water to prevent obstruction of esophagus how long till psyllium to take effect? 24 hours what needs to be increased in pt taking psyllium? fluids docusate sodium side effects? diarrhea, nausea, cramps, dizziness, PALPITATIONS, syncope (sign of dehydration) what should pt report when using docusate sodium? unrelieved constipation what is diphenoxylate and atropine used for? slowing peristalsis to alleviate diarrhea why is diphenoxylate atropine for short term use? b/c schedule V drug so preventing dependency priority nursing assessment for vomiting? symptoms that precipitate it and electrolyte status with pancreatitis when does it hurt most and where is the pain located? after a meal, pain in the epigastric area that radiates to the back what do you give pancrelipase with? food nursing assessments for pancrelipase? pork allergy/ religious beliefs what should you see with effective pancrelipase treatment?
decrease in steatorrhea omeprazole is used for what and how long is therapy? for peptic ulcers & GERD short term use: 4-8 wks with continued use of omeprazole what is the pt at risk for and what should you teach them to prevent this?
- osteoporosis
- increase calcium and vit. D When should omeprazole be taken? 30 mins before 1st meal of day side effects of ranitidine? HEADACHE what can occur in men taking ranitidine? impotence, loss of libido what should be avoided taking within an hour of ranitidine administration antacid when should ranitidine be given? at bedtime with no regard to food common side effect of aluminum hydroxide? constipation what symptoms can indicate a more serious disease when on ranitidine therapy? epigastric pain, bloody tarry stools, heartburn what does sucralafate do? coats ulcer and prevents erosion can sucralafate be taken with antacids? no when should sucralafate be administered? take on empty stomach before meals and before bedtime what should pt increase with sucralafate? fluids and fiber
agranulocytosis (infection risk) what does radioactive iodide do? destroy follicular cells to treat hyperthyroidism pt teaching for radioactive iodide therapy
- they will need thyroid hormone replacement after
- avoid pregnant women/children for 1 week insulin side effects hypoglycemia hypokalemia (inverse relationship with insulin) insulin glargine long acting up to 24 hr onset at 1.1 hr insulin lispro onset 15 min peak 1 hr duration 3 hr insulin regular onset 30-60 min peak 1-5 hr duration 6-10 hr NPH insulin onset: 1.5 hours peak: 6-14 hours duration: 16-24 hours mixing insulin steps NPH air then regular air then regular draw then NPH draw How does glipizide work? Stimulates insulin secretion from pancreatic islets what should pt avoid with glipizide alcohol does metformin stimulate insulin secretion?
no how does metformin work? Decreases the hepatic glucose production and increases peripheral glucose uptake (decrease resistance) acarbose blocks enzymes where? small intestine, Block enzymes in small intestine responsible for breaking down complex carbohydrates into monosaccharides Rosiglitazone works by Decreases the hepatic glucose production and increases peripheral glucose uptake (decrease resistance)
- same as metformin how long till optimal lowering of glucose with rosiglitazone 3 - 4 months common side effects of rosiglitazone? weight gain, fluid retention, headache repaglinide works by stimulating insulin secretion from pancreatic islet cells
- same as glipizide antithyroid drugs are hard on which organ so assess which labs?
- liver
- AST & ALT most common side effect of morphine constipation most serious side effect of morphine resp. depression what should nurse monitor before giving morphine? respirations opioid overdose is treated with naloxone sumatriptan is used for migraine headaches by vasoconstriction of blood vessels in brain when should you take sumatriptan and how many times can you repeat?
no acetaminophen antidote acetylcysteine max dose of acetaminophen daily. what if older or liver disease? 4000 mg, 2000 mg aspirin can reduce the risk of what? dose? stroke or MI. 81 mg/day aspirin can interact with which herbals ginkgo, ginseng, garlic side effects of asprin gi irritation, diarrhea what should you give with aspirin food, milk, or large amount of water who should you avoid aspirin in? hx of peptic ulcer is aspirin ototoxic yes Salicylate poisoning tinnitus, bleeding, can cause seizures common side effect of NSAIDs so give with? GI irritation give with food, milk, large amount of water NSAIDs are hard on which organ so what labs do you monitor nephrotoxic (kidney), BUN, Creatinine signs of hypercalcemia Drowsiness, lethargy, headache, anorexia, increased urination and thirst, confusion, coma, renal stones (report dysuria, flank pain) Most serious: Dysrhythmia/cardiac arrest alendronate is used for
prevention and treatment of osteoporosis side effects of alendronate jaw pain, blurred vision, dysphagia r/t esophagitis raloxifene works by decreasing bone resorption and increasing bone mass/density which herbal may interfere with raloxifene? black cohosh side effects of raloxifene hot flashes, leg cramps, weight gain, thromboembolism pt teaching when using hydroxchloroquine GI disturbances (take with milk/food); avoid use with hepatotoxic drugs, eliminate use of alcohol, take everyday at the same time, photophobia is common-sunglasses methotrexate watch for bleeding (thrombocytopenia) hydrochloroquine and methotrexate are used to relieve severe inflammation allopurinol is used for gout, controls hyperuricemia how long till uric acid levels back to normal with allopurinol treatment 1 - 3 weeks what should pt increase with allopurinol? fluid: 2-3L per day what should you monitor with furosemide use?
- electrolytes
- BP
- Urine output what time of day should you take furosemide? morning when should you hold use of furosemide?
which drugs increase the risk for hyperkalemia with potassium supplement administration interactions? ACE inhibitor, potassium sparing diuretic what is sodium bicarbonate used to treat? acidosis Side effects of sodium bicarbonate metabolic alkalosis hypokalemia Who is sodium bicarb contraindicated in vomiting, continuous GI suction cardiac disease and renal impairment htn, peptic ulcers which food is contraindicated with sodium bicarb and why? milk/calcium due to milk alkali syndrome with potassium replacement therapy what should you monitor for? cardiac abnormalities who is potassium replacement therapy contraindicated in? dehydration, heat cramps, digoxin intoxication with A V node distrubances estradiol and norethindrone side effects edema, nausea, abdominal cramps Dysmenorrhea, breast tenderness, fatigue Skin rash, acne, headache, weight gain Midcycle breakthrough bleeding, vaginal candidiasis Photosensitivity, changes in urinary patterns Serious cardiovascular side effects more common in smokers What should a patient do if they miss one dose/two doses/three doses of oral contraceptive?
- if one dose: take it nest day with next dose
- if two dose: make both up next day with next day dose
- if three dose: restart on next cycle which herbal used with estrogen replacement therapy can interfere? black cohosh what are androgens used for?
- hypogonadism
- increase libido
- correct erectile dysfunction does slidanefil cause an erection? no only enhances it what finasteride use for? decrease enlarged prostate how long till effects of finasteride are reached? 6 - 12 months most common side effect of diphenhydramine sedation how to use steroid inhaler?
- first time use prime the inhaler, 2) clear the nose by blowing it, 3) instill the medication, 4) rinse the mouth and spit out any excess fluid how long should you use oxymetazoline? 3 to 5 days do not exceed because will cause rebound congestion side effects of oxymetazoline hypertension, headache, CNS stimulation, tachycardia, nervousness What does dextromethorphan do to your cough? suppresses it (antitussive) what should you avoid with dextromethorphan? smoking and alcohol which medication increases mucus flow and improves cough productivity? guaifenesin (expectorant) what should you warn a pt about use of acetylcystiene? has strong foul odor so might cause n/v what is acetylcystiene indicated for and how does it work?
- cystic fibrosis, chronic bronchitis
- directly breaks down and loosen thick viscous secretions
- delivered via inhalation route
bedtime b/c drowsiness how often is montelukast give? what if they are excercising? usually given every 24 hours; except when given for exercise induced bronchospasms then 2 hours prior to exercise (NOT rescue inhaler). what can the granules of montelukast be taken with? soft foods like applesauce, carrots, rice, ice cream how long till effects of montelukast are seen? 1 week side effects of montelukast? (Hint: Neuropsychiatric) Headache, cough, nasal congestion, GI upset, drowsiness, Neuropsychiatric effects: DEPRESSION, behavior changes, hallucinations, suicidal ideation) - a medication change may be advised describe the half life of cromolyn? short must be inhaled 4 to 6 times a day avoid taking atoravastatin with? grapefruit juice biggest side effect of atoravastatin? muscle pain, weakness, rhabdomyolysis when should you take atoravastatin? evening cholestyramine side effects? bloating and constipation which tests to you monitor with cholestyramine? liver function, caution with PUD who should you not use gemfibrozil in? hx of gallbladder disease enalapril and captopril are used to treat (HINT: 5) Hypertension Heart failure MI (decreases risk of heart failure and left ventricular function)
Diabetic and non-diabetic neuropathy Reduce risk for a CV event which electrolyte do you retain with ACE inhibitors (-prils) potassium side effects of enalapril and captopril and interventions for them? cough (discontinue med switch to another) angioedema (stop med, push epinephrine) hyperkalemia (avoid salt substitutes) when should ACE inhibitors be taken? 1 hour before meal drug interactions with ACE inhibitors (HINT: 4) Diuretics (hydrochorothiazide) contribute to first-dose hypotension Antihypertensive (clonidine) have an additive effect when used together Antihypertensive (aliskiren) a direct renin inhibitor can intensify first dose effect Ace inhibitors can increase levels of lithium carbonate should losartan be used during pregnancy no fetal injury during 2nd and 3rd trimester complications of losartan angioedema, hypotension what should you obtain prior to verapamil (calcium channel blocker) therapy? ECG, BP, Pulse which food can lead to verapamil toxicity? grapefruit juice when should hold the dose of verapamil? pulse less than 60 doxazosin can be used to treat hypertension or BPH manifestations when should the first dose of doxazosin be given bedtime due to orthostatic effect and ensure safety for pt give with food how does metoprolol work?
lab changes that indicated a Myocardial Infarction troponin, CK-MB, CK which lab do you monitor with heparin? aPTT what reverses effects of heparin? protamine sulfate what labs do you monitor with warfarin? PT/INR when should warfarin be given? orally in eveing what reverses warfarin effects? vitamin K what route is exoxaparin given? subQ in abdomen do you need labs frequently drawn with enoxaparin? no does heparin dissolve clots? no its stops progression of clot formation what herbals increase risk of bleeding? garlic, ginger, ginseng, gingko, feverfew, green tea what category is warfarin? X can warfarin and heparin be administered at the same? yes because warfarin takes several days to take effect so when the levels are reached heparin is removed how many days prior to surgery should pt stop taking anticoagulants? 5 days prior What is reteplase? Dissolve clots obstructing coronary arteries
side effect of reteplase? particularly excessive bleeding when giving thrombolytics what are you monitoring for? Monitor IV sites for bleeding, redness, pain (pressure for up to 30 minutes) Monitor for bleeding from gums, mucous membranes, nose Observe for signs of internal bleeding (decreased BP, restlessness, increased pulse) amiodarone increases risk for which drug toxicity? digoxin what must you have alongside epoetin alfa to stimulate erythropoesis? iron who is epoetin alfa contraindicated in? uncontrolled hypertension what should diet look like for epoetin alfa therapy? iron rich cyanocobalamin is used for what and is only effective if what is present?
- b12 deficiency
- effective if intrinsic factor is present adverse effects of cyanocobalamin uncommon, Hypokalemia, arthralgia, dizziness, headache who is cyanocobalamin contraindicated in> severe pulmonary disease, heart failure when should ferrous sulfate be taken? between meals to increase absorption how should liquid preparation of ferrous sulfate be given? dilute with water or juice or sip through a straw place in back of mouth-rinse after what reduces absorption of ferrous sulfate? Antacids, PPI, CaCl Dairy products what can be given with iron to increase absorption?
what tests need to be monitored with pyrazinamide LFT infusion alerts for amphotericin? (hint: 3) Slow infusion Pre-medicate (acetaminophen, antihistamines, corticosteroids) to reduce hypersensitivity Hold with elevated creatinine/BUN nystatin should be stored at room temperature when should you take nystatin and how after eating b/c unpleasant taste swish and swallow (2 minutes) first line drug for herpes virus acyclovir nursing management for chemotherapy severe vomiting so attend to metabolic alkalosis adverse effects of chemotherapy and pt teaching for it Bone marrow suppression
- Decreased platelet count-thrombocytopenia avoid straight razors (electric ok) Bleeding gums soft toothbrush; thorough dental care Bruising Decreased leukocyte count
- Increased risk of infection Avoid crowds especially where risk of infection high Avoid fresh fruits and fresh fruits and vegetables Be aware of potential contaminants associated with plants and flowers
- Decreased erythrocyte count Fatigue, SOB because chemotherapy reduces absolute neutrophil count what are some precautions as a nurse to take Neutropenic precautions Low-bacteria diet (eliminate raw fruits and vegetables, undercooked meat, fish or eggs, and pepper) No rectal temperatures to reduce introducing bacteria for a from the rectum into the blood Limit visitors to healthy adults Brush teeth with soft tooth brush and avoid flossing
