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NURS 6630 Midterm Exam 3 Pharm Week 6.
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NURS 6630 Midterm Exam 3 Pharm Week 6.
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A I39-year-old Ipatient Iwho Iis Ihaving Itrouble Isleeping Iis Ibeginning Idrug Itreatment IwithIzaleplon I(Sonata). IThe Inurse Iwill Ibe Isure Ito Iask Ithe Ipatient Iif Ishe Iis Itaking
Response The Inurse Iwill Iassess Ifor Icimetidine Iuse. ICimetidine Igreatly Iincreases
IFeedback: Ithe Ilevel Iof Icirculating Izaleplon Iand Icould Icause Itoxic Ieffects Iin Ithe
Ipatient. ISecobarbital Iis Ia Ibarbiturate, Iand Ioxycodone Iand Imeperidine
Iare Inarcotics Ithat Iwould Inot Ibe Iused Iwith Ilorazepam Ibecause Ithe
Icombinations Imay Idepress Irespiratory Idrive, Icreate Isevere Ihypotension
Ior Ibradycardia, Iand Isubstantially Ialter Ilevel Iof Iconsciousness.
A I20-year-old Iman Ihas Ibegun Itreatment Iof Ithe Ipsychotic Isymptoms Iof Ischizophrenia
Iusing Iolanzapine I(Zyprexa). IWhich Iof Ithe Ifollowing Isymptoms Iwould Ibe Icategorized
Ias Ia Inegative Isymptom Iof Ischizophrenia?
Response The Inegative Isymptoms Iof Ischizophrenia Iinclude Iflat Ior Iblunted
IFeedback: Iemotions, Ilack Iof Ipleasure Ior Iinterest Iin Ithings I(anhedonia), Iand Ilimited
Ispeech. IThe Ipositive Isymptoms Iof Ischizophrenia, Iand Ithe Imost
Irecognizable Isymptoms, Iinclude Idelusions I(e.g., Iparanoia Ior Idistorted
Iperceptions Iof Iother Ipeople's Iintentions) Iand Ihallucinations.
A Inurse Iworks Iin Ia Isleep Idisorder Iclinic Iand Iis Iresponsible Ifor Iadministering
Imedications Ito Ithe Ipatients. IWhich Iof Ithe Ifollowing Ipatients Iwould Ibe Imost Ilikely Ito
Ireceive Izaleplon I(Sonata)?
Response The Inurse Iwill Imost Ilikely Iadminister Ithe Izaleplon Ito Ithe I35-year-old Iman
IFeedback: Iwho Iis Ihaving Idifficulty Ifalling Iasleep, Ibut Ionce Iasleep Ican Istay Iasleep.
IZolpidem Iwould Imost Ilikely Ibe Iadministered Ito Ithe I20-year-old Iwho Iwill
Itake Ia Isleep Iaid Ionly Ionce Ia Iweek. IEszopiclone I(Lunesta) Iwill Ibe Igiven Ito
Ithe I52-year-old Iwoman Iwho Ineeds Ito Ifall Iasleep Iquickly Iand Ihas Itrouble
Istaying Iasleep. IThe I46-year-old Iman Iwill Ilikely Ireceive Itrazodone
I(Desyrel). IThis Idrug Iis Igiven Ias Ia Isleep Iaid Ifor Ia Ipatient Iwho Iis Itaking Ian
Iantidepressant.
A I62-year-old Iwoman Ihas Ibeen Iprescribed Ia Ifentanyl Itransdermal Ipatch Ifor Ichronic
Icancer Ipain. IThe Ipatient Iasks Ithe Inurse Ihow Ilong Iit Iwill Itake Ifor Iher Ito Iexperience Ipain
Irelief. IThe Inurse Iwill Iinstruct Ithe Ipatient Ithat Ishe Ishould Ifeel Ipain Irelief Iin
Iapproximately
Response The Inurse Iwill Iinstruct Ithe Ipatient Ithat Iit Iwill Itake Iapproximately I24
IFeedback: Ihours Ifor Ithe Ifull Ipain-relieving Ieffect Iof Ia Ifentanyl Itransdermal Ipatch Ito
Ioccur.
A Inurse Iwill Ibe Iprepared Ito Iadminister Inaloxone I(Narcan) Ito Ia Ipatient Iwho Ihas Ihad Ian
Ioverdose Iof Imorphine. IRepeated Idoses Iof INarcan Iwill Ibe Inecessary Ibecause INarcan
Response The Iduration Iof Ithe Imorphine Imay Ibe Ilonger Ithan Ithe Iduration Iof
IFeedback: Inaloxone. ITherefore, Inaloxone Ihas Ia Ishorter Ihalf-life Ithan Imorphine.
IRepeated Idoses Imay Ibe Inecessary Ito Imaintain Ireversal Iof Ithe Iopiate's
Ieffects. INaloxone Idoes Inot Iincrease Ithe Iaction Iof Imorphine, Iand Iit
, Icauses Ithe Irespiratory Irate Ito Iincrease, Inot Idecrease. IDosage Istrength Iis
Inot Iassociated Iwith Idrug Iduration.
Which Iof Ithe Ifollowing Iwould Ibe Ian Iexpected Ioutcome Iin Ia Ipatient Iwho Ihas Ibeen Igiven
Iatropine Iduring Ia Imedical Iemergency?
Response Atropine Iis Iused Ito Ihelp Irestore Inormal Isinus Irhythm Iin Iemergency
IFeedback: Isituations, Isuch Ias Isymptomatic Ibradycardia, Ipulseless Ielectrical Iactivity,
Iventricular Iasystole, Ior Icardiopulmonary Iresuscitation. IIt Idoes Inot Iresolve
Iacid-based Iimbalances Ior Idecreased Ilevel Iof Iconsciousness Iand
Iatropine Iincreases, Irather Ithan Idecreases, Iblood Ipressure.
A I70-year-old Iwoman Iwho Iis Ion Ilong-term Iibuprofen Itherapy Ifor Iosteoarthritis Ihas
Ireturned Ito Ithe Iclinic Ifor Iher Iregular I6-month Ivisit. IIn Ithe Ilast Icouple Iof Imonths, Ishe Ihas
Ibeen Ihaving Iincreasing Iperiods Iof Iabdominal Ipain. IThe Inurse Isuspects Ithat Ithis Ipain
Imay Ibe Irelated Ito
Response During Ilong-term Iibuprofen Itherapy, Iespecially Iin Ipatients Iolder Ithan I60
IFeedback: Iyears, Ithe Inurse Ineeds Ito Iclosely Imonitor Ifor Ipeptic Iulcer Idisease Ior
Igastritis Ithat Ican Ilead Ito Igastrointestinal Ibleeding Ior Ieven Ibowel
Iperforation. IThese Ievents Ican Ioccur Iat Iany Itime, Iwith Ior Iwithout Iwarning.
IIbuprofen Imay Ialso Icause Iexcessive Ior Iabnormal Ibleeding, Iespecially Iin
Ipatients Iwith Ianemia, Ibut Iit Iis Inot Iknown Ito Icause Ianemia. IInterstitial
Inephritis Iis Ione Iof Ithe Iless Icommon Irenal Itoxicities Iassociated Iwith
Iibuprofen Ias Iis Iconstipation.
Following Ian Iassessment Iby Iher Iprimary Icare Iprovider, Ia I70-year-old Iresident Iof Ian
Iassisted Iliving Ifacility Ihas Ibegun Itaking Idaily Ioral Idoses Iof Ilevothyroxine. IWhich Iof Ithe
Ifollowing Iassessment Ifindings Ishould Iprompt Ithe Inurse Ito Iwithhold Ia Ischeduled Idose
Iof Ilevothyroxine?
Response If Ithe Ipulse Irate Iis Igreater Ithan I100 Ibpm, Iit Iis Inecessary Ito Iwithhold Ia
IFeedback: Ilevothyroxine Idose Iin Ian Iolder Iadult. IAnorexia, Irecent Ivaccination, Iand
Irecent Ifalls Ido Inot Inecessary Iindicate Ia Ineed Ito Iwithhold Ithis
Imedication.
During Ilong-term Idesmopressin Itherapy Iin Ia I48-year-old Iwoman, Iit Iwill Ibe Imost
Iimportant Ifor Ithe Inurse Ito Iassess Iwhich Iof Ithe Ifollowing?
Response During Ilong-term Idesmopressin Itherapy, Ithe Inurse Ishould Iperiodically
IFeedback: Iassess Ithe Ipatient's Inasal Ipassages Ibecause Iinappropriate
Iadministration Iof Ithe Idrug Imay Ilead Ito Inasal Iulceration. IConsequently,
Isubsequent Idoses Imay Ibe Iinadequate. IGeneral Iskin Iassessment, Idiet,
Iand Ienvironment Iare Ialso Ifactors Ithat Ineed Ito Ibe Iassessed, Ibut Ithese Iare
Inot Ias Iimportant Ias Iassessing Ithe Ipatient's Inasal Ipassages.
A Imale Ipatient Iis Ito Ibegin Iglyburide I(Diabeta) Ifor Itype I2 Idiabetes. IBefore Ithe Idrug
Itherapy Ibegins, Ia Ipriority Iaction Iby Ithe Inurse Iwill Ibe Ito Iassess Ithe Ipatient's
Response The Inurse Ishould Iassess Ithe Ipatient's Ialcohol Iconsumption Ibefore
IFeedback: Itherapy Iis Iinitiated. IConcomitant Ialcohol Iuse Iincreases Ithe Irate Iof
, Iglyburide Imetabolism Iand Imay Icause Ia Idisulfiram-like Ireaction. IEven
Ithough Ithe Ipatient's Iblood Ipressure Ishould Ibe Iassessed, Iit Iis Inot Ias
Iimportant Ias Imaking Isure Ithat Ithe Ipatient Iis Iaware Iof Ithe Iserious Ireaction
Ithat Ialcohol Ican Icause Iwhile Ion Iglyburide. IThe Iamount Iof Isalt Iused Iin Ithe
Ipatient's Idiet Iis Iimportant Ias Iwell Ias Ithe Ipatient's Ipotassium Ilevel, Ibut Inot
Ispecifically Iin Irelation Ito Ithe Iuse Iof Iglyburide.
A Ipatient Iwith Itype I1 Idiabetes Ihas Ibeen Iadmitted Ito Ithe Ihospital Ifor Iorthopedic Isurgery
Iand Ithe Icare Iteam Ianticipates Isome Idisruptions Ito Ithe Ipatient's Iblood Iglucose Ilevels Iin
Ithe Idays Ifollowing Isurgery. IWhich Iof Ithe Ifollowing Iinsulin Iregimens Iis Imost Ilikely Ito
Iachieve Iadequate Iglycemic Icontrol?
Response Subcutaneous Iinsulin Itherapy Ifor Itype I1 Idiabetes Ifrequently Iconsists Iof
IFeedback: Idaily Iinjections Iof Imixtures Iof Ishort-acting Iregular Iinsulin Iwith
Iintermediate-acting Iinsulins; Imultiple Idoses Iof Iregular Iinsulin Ibefore Ieach
Imeal Iin Iassociation Iwith Ione Ior Itwo Idaily Idoses Iof Ilong-acting Iinsulin Imay
Ialso Ibe Iused. IFrequent, Ifixed Idoses Iof Irapid-acting Ior Iintermediate-
acting Iinsulin Imay Iresult Iin Iunsafe Iblood Isugar Ilevels.
A I49-year-old Iwoman Ihas Ibeen Idiagnosed Iwith Imyalgia. IThe Iphysician Ihas
Irecommended Iaspirin. IThe Ipatient Iis Iconcerned Ithat Ithe Iaspirin Iwill Iupset Iher
Istomach. IThe Inurse Iwill Iencourage Ithe Ipatient Ito
Response Taking IIaspirin IIwith IImilk IIor IIfood IIminimizes IIthe IIstomach IIupset IIbecause
IIFeedback: IIit IIbuffers IIthe IIstomach IIwall IIfrom IIdirect IIcontact IIwith IIthe IImedication,
IIdecreasing IIgastric IIdistress. IIChewable IItablets IIcan IIbe IIchewed IIbefore
IIswallowing IIor IIcrushed IIand IIthen IIadvised IIto IIbe IItaken IIwith IIfood IIor
IImixed IIin IIa IIdrink. IISwallowed IIwhole, IIextended-release IItablets IIare
IIenteric IIcoated IIto IIdelay IIrelease IIof IIthe IIaspirin, IIwhich IIagain IIbuffers IIthe
IIstomach IIwall IIfrom IIthe IImedication, IIdecreasing IIgastric IIdistress.
IINonchewable IItablets IIshould IIbe IIswallowed IIwhole IIand IIshould IInever IIbe
IIadvised IIto IIbe IIcrushed IIor IIchewed.
A Inurse Ihas Ibeen Iinvited Ito Ispeak Ito Ia Isupport Igroup Ifor Ipersons Iwith Imovement
Idisorders Iand Itheir Ifamilies. IWhich Iof Ithe Ifollowing Istatements Iby Ithe Inurse Iaddresses
Ithe Ichronic Inature Iof Ithese Idiseases Iand Ithe Irelevant Idrug Itherapies?
Response It Iis Imost Iimportant Ithat Ipatients Iand Itheir Ifamilies Iknow Ithat Imovement
IFeedback: Idisorders Iare Ichronic, Ithat Ithere Iis Ino Icure, Iand Ithat Idrug Itherapy Ionly
Iserves Ito Ihelp Idecrease Ithe Iseverity Iof Ithe Isymptoms. ISymptoms Iare Inot
Inormally Ieliminated Icompletely. ICulture Imust Ibe Iconsidered Ibecause Iof
Icatecholamine-O-methyltransferase I(COMT), Iwhich Iaffects Ithe
Iabsorption Iof Ilevodopa Iin Ithe Ibody. ISome Iof Ithe Idrugs Iused Ito Itreat
Imovement Idisorders Ican Ipose Ia Irisk Iof Icausing Irenal Ior Ihepatic
Idysfunction, Ibut Inot Iall.
A Inurse Iwill Iinstruct Ia Ipatient Itaking Iallopurinol Ito Itake Ieach Idose
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