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Introduction to Clinical Pharmacology 9th Edition
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Test Bank for Introduction to Clinical Pharmacology 9th Edition (Visovsky, 2019), Chapter 1-19 Complete Guide.
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Test Bank For Introduction to Clinical Pharmacology9th Edition By Constance G Visovsky; Cheryl H
Zambroski; Shirley Hosler 9780323529112 Chapter 1-19
Complete Guide .
Important monitoring for Clonazepam - ANSWER: Respiratory rate since Clonazepam is a CNS
depressant
A 38-year-old man has come into the urgent care center with severe hip pain after falling from a
ladder at work. He says he has taken several pain pills over the past few hours but cannot remember
how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol). The nurse is
aware that the most serious toxic effect of acute acetaminophen overdose is which condition?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephropathy - ANSWER: ANS: C
Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen.
When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to
penicillin. Based on this finding, the nurse would question an order for which class of
antibiotics?
a. Tetracyclines
b. Sulfonamides
c. Cephalosporins
d. Quinolones - ANSWER: ANS: C
Allergy to penicillin may also result in hypersensitivity to cephalosporins.
The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which
statement by the nurse is correct?
a. "Avoid direct sunlight and tanning beds while on this medication."
b. "Milk and cheese products result in increased levels of tetracycline."
c. "Antacids taken with the medication help to reduce gastrointestinal distress."
d. "Take the medication until you are feeling better." - ANSWER: ANS: A
Drug-related photosensitivity occurs when patients take tetracyclines, and it may continue for
several days after therapy. Milk and cheese products result in decreased levels of tetracycline
when the two are taken together. Antacids also interfere with absorption and should not be
taken with tetracycline. Counsel patients to take the entire course of prescribed antibiotic
drugs, even if they feel that they are no longer ill.
The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an
infection. Which laboratory value would indicate therapeutic effectiveness of this therapy?
a. Increased red blood cell count
b. Increased hemoglobin level
c. Decreased white blood cell count
d. Decreased platelet count - ANSWER: ANS: C
Decreased white blood cell counts are an indication of reduction of infection and are a
therapeutic effect of antibiotic therapy.
,During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary
instructions?
a. Using iodized salt when cooking
b. Avoiding foods containing iodine
c. Restricting fluid intake to 2500 mL/day
d. Increasing intake of sodium- and potassium-containing foods - ANSWER: ANS: B
Patients on antithyroid therapy need to avoid iodine-containing foods. These foods may interfere with
the effectiveness of the antithyroid drug.
When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse
will monitor for which adverse effect?
a. Decreased glucose levels
b. Decreased white blood cell count
c. Increased red blood cell count
d. Increased platelet count - ANSWER: ANS: B
Antithyroid drugs may cause bone marrow suppression, resulting in agranulocytosis,
leukopenia, thrombocytopenia, and other problems.
A cholinergic drug is prescribed for a patient with a new diagnosis of myasthenia gravis, and
the nurse provides instructions to the patient about the medication. What is important to
include in the teaching?
a. Take the medication with meals to avoid gastrointestinal distress.
b. Give daytime doses close together for maximal therapeutic effect.
c. Take the medication 30 minutes before eating to improve swallowing and
chewing.
d. Take the medication only if difficulty swallowing occurs during a meal. - ANSWER: ANS: C
Taking the medication 30 minutes before meals allows time for the onset of action and
therapeutic effects during the meal. The doses should be spaced evenly apart to optimize the
effects of the medication.
The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer's
disease. She was diagnosed 3 months ago, has mild memory loss, and will be receiving donepezil
(Aricept). What is the drug's expected action?
a. Prevents memory loss in later stages
b. Reverses the course of Alzheimer's disease
c. Provides sedation to prevent agitation and restlessness
d. May help to improve the mood and decrease confusion - ANSWER: ANS: D
Donepezil is used to treat mild-to-moderate dementia occurring in Alzheimer's disease and may
improve the symptoms of the disease.
A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The
patient asks the nurse why he has to be on two medications. The nurse's response is based on
which rationale?
a. The oral and injection forms work synergistically.
b. The combination of heparin and an oral anticoagulant results in fewer adverse
effects than heparin used alone.
c. Oral anticoagulants are used to reach an adequate level of anticoagulation when
heparin alone is unable to do so.
d. Heparin is used to start anticoagulation so as to allow time for the blood levels of
warfarin to reach adequate levels. - ANSWER: ANS: D
This overlap therapy is required in patients who have been receiving heparin for
anticoagulation and are to be switched to warfarin so that prevention of clotting is continuous.
This overlapping is done purposefully to allow time for the blood levels of warfarin to rise, so
that when the heparin is eventually discontinued, therapeutic anticoagulation levels of
warfarin will have been achieved. Recommendations are to continue overlap therapy of the
heparin and warfarin for at least 5 days; the heparin is stopped after day 5 when the
, international normalized ratio (INR) is above 2.
A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/min.
What will the nurse do next?
a. Administer the dose.
b. Administer the dose, and notify the prescriber.
c. Check the radial pulse for 1 full minute.
d. Withhold the dose, and notify the prescriber. - ANSWER: ANS: D
Digoxin doses are held and the prescriber notified if the apical pulse is 60 beats/min or lower
or is higher than 100 beats/min.
A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will
monitor laboratory results for which therapeutic effect?
a. Decreased uric acid levels
b. Decreased prothrombin time
c. Decreased white blood cell count
d. Increased hemoglobin and hematocrit levels - ANSWER: ANS: A
Treatment of gout with allopurinol should result in decreased uric acid levels.
A patient in the intensive care unit has a nasogastric tube and is also receiving a proton pump
inhibitor (PPI). The nurse recognizes that the purpose of the PPI is which effect?
a. Prevent stress ulcers
b. Reduce bacteria levels in the stomach
c. Reduce gastric gas formation (flatulence)
d. Promote gastric motility - ANSWER: ANS: A
Stress-related mucosal damage is an important issue for critically ill patients. Stress ulcer
prophylaxis (or therapy to prevent severe gastrointestinal [GI] damage) is undertaken in
almost every critically ill patient in an intensive care unit and for many patients on general
medical surgical units. Procedures performed commonly in critically ill patients, such as
passing nasogastric tubes, placing patients on ventilators, and others, predispose patients to
bleeding of the GI tract. Guidelines suggest that all such patients receive either a histamine
receptor-blocking drug or a proton pump inhibitor.
A patient has a new prescription for tamsulosin (Flomax) as treatment for benign prostatic
hyperplasia. The nurse is checking his current medication list and will contact the prescriber regarding
a potential interaction if the patient is also taking which drug?
a. Levothyroxine (Synthroid) for hypothyroidism
b. Sildenafil (Viagra), an erectile dysfunction medication
c. Omeprazole (Prilosec), a proton pump inhibitor
d. Low-dose aspirin for stroke prevention - ANSWER: ANS: B
Drugs that interact with alpha blockers such as tamsulosin include erectile dysfunction drugs; additive
hypotensive effects may occur.
A female patient will be starting therapy with oral isotretinoin (Amnesteem) as part of
treatment for severe acne, and the nurse is providing teaching. Which teaching point will the
nurse include in her teaching plan about isotretinoin?
a. "You will have to use two contraceptive methods while on this drug."
b. "You must avoid sexual activity while on this drug."
c. "You will have to avoid pregnancy for 2 weeks after taking this drug."
d. "If you are taking an oral contraceptive, you may take this drug." - ANSWER: ANS: A
It is now required that at least two contraceptive methods be used by sexually active women
during and for 1 month after completion of therapy with isotretinoin.
A patient is receiving lactulose (Enulose) three times a day. The nurse knows that the patient is not
constipated and is receiving this drug for which reason?
a. High ammonia levels due to liver failure
b. Prevention of constipation
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