EXIT HESI- PHARMACOLOGY TEST BANK GRADED A
A nurse is assessing the therapeutic action of drugs classified as tumor necrosis factor (TNF)
inhibitors. What client response indicates to the nurse that a drug with this classification is effective?
Continued remission in a client with ovarian can...
EXIT HESI- PHARMACOLOGY TEST BANK GRADED A
A nurse is assessing the therapeutic action of drugs classified as tumor necrosis factor (TNF)
inhibitors. What client response indicates to the nurse that a drug with this classification is effective?
Continued remission in a client with ovarian cancer
Increased insulin production in a client with diabetes mellitus
Reduction of inflammatory joint pain in a client with rheumatoid arthritis
Vasodilation of coronary arteries in a client with ischemic heart disease Reduction of
inflammatory joint pain in a client with rheumatoid arthritis
TNF is produced mainly by macrophages in synovium; over time, through various mechanisms, the
presence of TNF causes inflammation of synovium, destruction of bone and cartilage, joint stiffness,
and pain. TNF inhibitors or blockers neutralize TNF, thereby interrupting the inflammatory cascade;
this inhibits the inflammatory response and other mechanisms, thereby slowing tissue damage. TNF
inhibitors are not prescribed for clients with ovarian cancer, diabetes mellitus, or ischemic heart
disease.
The nurse suspects serotonin syndrome in a client prescribed second-generation antidepressants for
depression. Which assessment findings observed by the nurse would be beneficial in diagnosing the
severity of the syndrome?
Delirium
Hyperreflexia
Hyperthermia
Muscle spasms
Rhabdomyolysis Hyperthermia
,Rhabdomyolysis
Serotonin syndrome is a potentially hazardous adverse effect of second-generation antidepressants
that are used to treat depression. Hyperthermia and rhabdomyolysis are symptoms observed in
severe cases of serotonin syndrome. Delirium, hyperreflexia, and muscle spasms are common
symptoms of this syndrome.
A healthcare provider prescribes enoxaparin 30 mg subcutaneously daily. Which measure would the
nurse take when administering this medication?
Push over 2 minutes.
Administer in the abdomen.
Rub site after administration.
Remove air pocket from prepackaged syringe before administration. Administer in the abdomen.
Enoxaparin specifically targets blood clots throughout the body and carries a lower risk of
hemorrhage than that associated with the drugs heparin and warfarin. Enoxaparin is administered
once a day through a subcutaneous injection site around the naval. Enoxaparin should be injected
into the fatty tissue only, which is why the abdomen is the recommended injection site. Avoid
administering in a muscle. Manufacturer recommendations indicate the air pocket from prepackaged
syringes not be removed before administration. Rubbing the site is contraindicated, as it can cause
bruising. There are no recommendations to push this subcutaneous medication over 2 minutes.
A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a thiazide diuretic. Why
did the provider add spironolactone to the client's medication regimen?
To stimulate sodium excretion
To help prevent potassium loss
,To increase urine specific gravity
To reduce arterial blood pressure To help prevent potassium loss
Spironolactone is a potassium-sparing diuretic often used in conjunction with thiazide diuretics. The
provider was prompted to add spironolactone to the chlorothiazide to prevent potassium loss. Both
medications stimulate sodium excretion. Both medications increase urine specific gravity and reduce
arterial blood pressure.
A client with myasthenia gravis improves and is discharged from the hospital. The discharge
medications include pyridostigmine bromide 10 mg every 6 hours. The nurse evaluates that the drug
regimen is understood when the client makes which statement?
"I will take the medication on an empty stomach."
"I need to set an alarm so I take the medication on time."
"It will be important to check my heart rate before taking the medication."
"I should monitor for an increase in blood pressure after taking the medication." "I need to set an
alarm so I take the medication on time."
Pyridostigmine is a vital drug that must be taken on time; a missed or late dose can result in severe
respiratory and neuromuscular consequences or even death. Pyridostigmine should be taken with a
small amount of food to prevent gastric irritation. It is unnecessary to take the pulse rate before
taking pyridostigmine. Pyridostigmine may cause hypotension, not hypertension, which is a sign of
cholinergic crisis.
A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the follow-up
appointment, the client reports tremors, shortness of breath, a fever, and sweating. What will the
nurse do?
Call 911 and have the client transported to the nearest psychiatric unit.
Take the client's vital signs and arrange for immediate transfer to a hospital.
, Check the number of risperidone tablets left in the prescription bottle to see whether there was an
overdose.
Request a prescription for 2 mg of intramuscular benztropine stat and assess the client in 10 to 15
minutes for symptom relief. Take the client's vital signs and arrange for immediate transfer to a
hospital.
These clinical manifestations signal the presence of neuroleptic malignant syndrome; the cardinal
sign of this condition is a high body temperature. Therefore the nurse first should document the
hyperthermia and then arrange for immediate hospitalization. Unless the client is experiencing
impaired ventilation, it is important to complete a focused assessment before transfer. The care
needed can be provided in an emergency department or medical unit, not a psychiatric unit.
Neuroleptic malignant syndrome may occur without an overdose; this syndrome can occur when a
high-potency antipsychotic drug is prescribed, with typical onset within 3 to 9 days after initiation of
the medication. Benztropine will have little or no effect on neuroleptic malignant syndrome.
The health care provider prescribes an oral hypoglycemic for the patient with type 2 diabetes. What
will the nurse need to consider when developing the teaching plan?
Oral hypoglycemics work by decreasing absorption of carbohydrates.
Oral hypoglycemics work by stimulating the pancreas to produce insulin.
Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.
Clients with type 2 diabetes do not need to be concerned about serious adverse effects from oral
hypoglycemics. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a
sense of control.
Taking a tablet may give the client a false sense that the disease is under control, and this can lead to
dietary indiscretions. Some oral hypoglycemics work by stimulating the pancreas to produce insulin,
others work by decreasing carbohydrate absorption, and others work in a variety of other ways;
therefore teaching should be specific to the drug prescribed. Oral hypoglycemic drugs can have
serious adverse effects.
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