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RNSG 1301 Pharmacology Exam 1 2025
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A nurse is preparing to teach a forgetful older adult patient about a multiple drug regimen to follow after discharge from the hospital. To help promote adherence, what will the nurse do? Cluster medication administration times as much as possible. A nurse is reviewing a patient's medical record before administering a medication. Which factor(s) can alter the patient's physiologic response to the drug? (Select all that apply.) Age Genetic factors Gender
A nurse is reviewing nursing actions for emergency treatment of malignant hyperthermia with a group of nursing students. Which statement by a student indicates a need for further teaching? "Analgesics should be given to help with muscle pain." 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? During the first trimester A nurse is teaching a group of nursing students about neuromuscular blocking agents. For what may these agents be used? (Select all that apply.) Electroshock therapy Mechanical ventilation Surgery 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 patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely? Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body A patient has allergies and takes an antihistamine. The patient wants to know how the drug works. The nurse understands that antihistamines work because they are what? Antagonists A patient has been receiving an antibiotic with a small therapeutic index for 10 days. Upon assessment, the nurse suspects that the patient may be experiencing toxicity. What would be the nurse's priority action? Ask the prescriber to order a plasma drug level test.
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? This patient has developed pharmacodynamic tolerance, which has increased the minimal effective concentration (MEC) needed for analgesic effect. A patient has developed muscarinic antagonist toxicity from ingestion of an unknown chemical. The nurse should prepare to administer which medication? Physostigmine (Antilirium) 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? Tell the patient not to drink wine while taking the Lortab.
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 _____. higher; X A patient is to receive a beta agonist. Before administration of this medication, which assessment finding would most concern the nurse? Heart rate of 110 beats per minute A patient is wheezing and short of breath. The nurse assesses a heart rate of 88 beats per minute, a respiratory rate of 24 breaths per minute, and a blood pressure of 124/78 mm Hg. The prescriber orders a nonspecific beta agonist medication. Besides evaluating the patient for a reduction in respiratory distress, the nurse will monitor for which side effect? Tachycardia
A patient received atropine intravenously before surgery. The recovery room nurse notes that the patient is delirious upon awakening, has a heart rate of 96 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 110/78 mm Hg. The nurse notifies the anesthesiologist, who will order: an acetylcholinesterase inhibitor to compete with the antimuscarinic agent at receptors. A patient receives a neuromuscular blocking agent before a procedure. The patient's eyes close. The nurse knows this is a sign that the patient: is beginning to feel the drug's effects 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? That her baby's health is dependent on hers
A prescriber has ordered methyldopa for a female patient with hypertension. The nurse understands that which laboratory tests are important before beginning therapy with this drug? (Select all that apply.) Coombs' test Hemoglobin and hematocrit (H&H) Liver function tests An adult male patient is 1 day postoperative from a total hip replacement. On a pain scale of 0 to 10, with 10 being the greatest pain, the patient reports a pain level of 10. Which medication would be most appropriate for the nurse to administer to this patient? 6 mg morphine sulfate intravenously Before administering a medication, what does the nurse need to know to evaluate how individual patient variability might affect the patient's response to the medication? (Select all that apply.) Family medical history
Patient's age Patient's diagnosis Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would the nurse use to evaluate a successful response? Increase in urine output Many medications list side effects that include dry mouth, constipation, and urinary retention. What kind of effects are these? Anticholinergic The nurse receives an order to give morphine 5 mg IV every 2 hours PRN pain. Which action is not part of the six rights of drug administration? Assessing the patient's pain level 15 to 30 minutes after giving the medication
A nurse is caring for a patient who has myasthenia gravis. The prescriber has ordered neostigmine (Prostigmin). An important initial nursing action before administration of the medication includes assessing: swallowing ability. 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.) Ask the patient about over-the-counter medications used. Contact the prescriber to request cytochrome P450 levels. Obtain a thorough diet history. Answers:
A nurse is explaining activation of beta2 receptors to some student nurses during a clinical rotation at the hospital. Which statement by a student demonstrates a need for further teaching? "Beta2 activation results in contraction of uterine muscle." A nurse is helping a nursing student who is administering a medication to a patient with myasthenia gravis. Which statement by the student indicates the need for further teaching? "I will let the patient sleep after giving the medication, because rest is important." 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? Observe the patient closely for such symptoms and prepare to treat them if needed.
While preparing a patient for a procedure in which a neuromuscular blocking agent will be used, the nurse reviews the patient's preprocedure laboratory values. Which abnormality would cause the most concern? Hypokalemia A nurse educator is conducting a continuing education class on pharmacology. To evaluate the learning of the nurses in the class, the nurse educator asks, "Which drug name is a generic drug name?" Which is the correct response? Acetaminophen A nurse is teaching a group of nurses about neuropharmacology. The nurse asks which classes of drugs act by reducing axonal conduction. Which response by a participant is correct? Local anesthetics A patient is experiencing toxic side effects from atropine, including delirium and hallucinations. Which medication will the nurse expect to administer?
Physostigmine Generic drugs drugs sold by their generic name; not brand (or trade) name products Brand name name given to a drug by the pharmaceutical company that developed it; also called a trade name Genetic drugs vs Brand name Once the patent on a brand name runs out manufactures develop genetic drugs which are intended work on in the same way (quality, dosage, strength, and route of administration). The bioavailability of the generic drugs may differ from the brand name. This is why providers might specify "dispense as written" so brand name product may use especially in drugs that have narrow safety margins.
< 15 mg hydrocodone per dosage unit (Vicodin) ; < 90 mg of codeine p3er dosage unit (Tylenol w/ codeine); ketamine; anabolic steroids; testosterone Written/Oral Rx that expired w/n 6mos. No more than 5 refills. Control substance - (C-IV) Schedule IV Less abuse potential than schedule III and limited dependence liability (some sedatives, antianxiety agents, and nonnarcotic analgesics) Examples: Xanax, Soma, Valium, Ativan, Talwin, Ambien Written/Oral Rx that expires w/n 6 mons. No more than 5 refills. Control substance - (C-V) Schedule V Limited abuse potential Cough suppressants < 200 mg codeine/100 mL (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin
Written Rx or OTC; must be 18 yo, ID must be showed, and dispensing must be recorded The Controlled Substances Act of 1970 Control over the coding of drugs and the enforcement of these codes to the FDA and the Drug Enforcement Agency (DEA), a part of the U.S. Department of Justice. Pregnancy category A Adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester of pregnancy, and there is no evidence of risk in later trimesters. Pregnancy category B Animal studies have not demonstrated a risk to the fetus but there are no adequate studies in pregnant women.
