Pharm Hesi v1 BSN 315 Questions and Answers
Nursing care for the postoperative patient requiring long-term glucocorticoid therapy will
be directed at overcoming what adverse effect of the drug?
A)Poor wound healing B)Inflammation C)Autoimmune response
D)Lack of mobility - ANSWER-Ans:AFeedback:
Patients taking long-term glucocorticoid therapy will have impaired wound healing so
nursing care is directed toward promoting healing. The drug has an anti-inflammatory
effect so that would not need to be overcome. There is no autoimmune response or lack
of mobility so these do not have to be overcome.
56.For what reason might the nurse administer sildenafil to a woman?
A)Pulmonary arterial hypertension B)Sexual dysfunctionC)Breast
cancerD)Endometriosis - ANSWER-Ans:A
Feedback:
Sildenafil is used to treat erectile dysfunction in the presence of sexual stimulation in
men and to treat pulmonary arterial hypertension in women. It is not used for sexual
dysfunction, breast cancer, or endometriosis in women.
A 12-year-old patient with a complicated skin infection has been admitted to the
pediatric unit. The physician has ordered Ertapenem (Invanz). What is the nursing
priority?
A)Transcribe the order to the medication administration record (MAR).
B)Perform hand hygiene before preparing the medication.
C)Assess the patient's renal and hepatic functions.
D)Question the order by calling the physician who prescribed it. - ANSWER-Ans:D
Feedback:
The nurse should call the physician and question the order Because this drug is not
recommended for children younger than 18 years of age. Following clarification of the
order, the drug would be transcribed and listed in the MAR. The nurse would then wash
her hands before preparing the drug for administration. Assessment of renal and
hepatic function is good practice before
administering any medication but is not the nursing priority.
A 16-year-old boy is diagnosed with delayed onset of puberty and the physician has
ordered testosterone, intramuscular (IM), once every 2 weeks. What nursing
intervention would be important to the patient?
A)Discuss changes that will occur in his body.
B)Have patient fast before injection.
C)Have patient reduce protein intake.
D)Decrease exercise while on this hormonal treatment. - ANSWER-Ans:A
Feedback:
It is important for this patient to understand what will happen and the changes he will
see to reduce the anxiety that could occur if he didn't understand. Discuss the
development of masculine characteristics as well as common adverse effects such as
,acne. Having the patient fast before the injection would not be necessary, nor would
decreasing exercise or reducing protein intake.
A 16-year-old girl comes to the clinic complaining of severe menstrual cramps. The girl
is concerned about the pain and worried that "something is wrong." The nurse explains
to the patient that she has cramping during her menstrual period because of what?
A)An increase in the levels of estrogen and progesterone, which cause uterine
contractions
B)Low levels of plasminogen in the uterus that cause the shedding of the lining of the
uterus
C)Prostaglandins in the uterus, which stimulate uterine contractions to clamp off vessels
as the lining of her uterus sheds
D)An increase in progesterone and a decrease of estrogen cause the lining of the
uterus to slough away - ANSWER-C Feedback:
Prostaglandins in the uterus stimulate uterine contractions to clamp off vessels in the
lining of the uterus, which is the cause of the cramping. The decrease of estrogen and
progesterone after the involution of the corpus luteum triggers the release of follicle-
stimulating hormone (FSH) and luteinizing hormone (LH). The decreased levels of FSH
and LH cause the inner lining of the uterus to slough off because the vascular system is
no longer being stimulated. High, not low, levels of plasminogen in the uterus prevent
clotting of the lining as the vessels shear off.
A 17-year-old male patient with athlete's foot is extremely upset that he cannot get rid of
it. He calls the clinic and asks the nurse whether the doctor can give him an antibiotic to
"cure the infection." What should the nurse include in the explanation of treatment for
fungal infections?
A)"Fungi differ from bacteria in that the fungus has flexible cell walls that allow for free
transfer into and out of the cell."
B)"Protective layers contain sterols, which change the membrane permeability."
C)"The composition of the protective layers of the fungal cell makes the organism
resistant to antibiotics."
D)"Fungi cell walls contain Candida, which makes the cells rigid. - ANSWER-Ans:C
Feedback:
The nurse should tell the patient that the composition of the protective layers of the
fungal cell makes the organism resistant to antibiotics so that antibiotics would not have
any positive effect. Fungi do differ from bacteria, but the fungus has rigid cell walls that
allow for free transfer in and out of the cell. The protective layers contain ergosterol, not
Candida, that helps keep the cell wall rigid, not permeable.
A 20-year-old female patient has been diagnosed with multiple sclerosis. What drug will
most likely be prescribed?
A)Baclofen (Lioresal) B)Cyclobenzaprine (Flexeril) C)Metaxalone (Skelaxin)
D)Orphenadrine (Banflex) - ANSWER-Ans:A
Feedback:
,Baclofen is used for treatment of muscle spasticity associated with neuromuscular
diseases such as multiple sclerosis. Cyclobenzaprine, metaxalone, and orphenadrine
are used for relief of discomfort associated with painful, acute musculoskeletal
conditions.
A 22-year-old female is diagnosed with mycobacterial tuberculosis. The physician
orders rifampin (Rifadin) 600 mg PO daily. What should the nurse question the patient
about?
A)Her dietB)Sun exposureC)Type of exercise she does D)Use of contact lenses -
ANSWER-Ans:DFeedback:
Some antimycobacterial drugs can cause discoloration of body fluids. The orange
tinged discoloration can cause permanent stain to contact lenses. The patient should
avoid wearing them while on the antimycobacterial therapy. With antimycobacterial
drugs there is not a concern is warranted about photosensitivity or exercise. However,
due to the GI adverse effects, the nurse may want to discuss an appropriate diet if the
patient experiences GI upset after beginning treatment.
A 28-year-old patient has been prescribed penicillin for the first time. What nursing
diagnosis would be most appropriate for this patient?
A)Acute pain related to gastrointestinal (GI) effects of the drug
B)Deficient knowledge regarding drug therapy
C)Imbalance nutrition: less than body requirements related to multiple GI effects of the
drug
D)Constipation - ANSWER-Ans:B Feedback:
Because this is the first time the patient has taken penicillin, she is likely to have limited
knowledge about the drug. She may not understand the importance of taking the
medication as ordered to increase effectiveness of the drug or to report adverse effects.
because the patient has not started the drug yet, there is no way to know what adverse
effects, if any, she will experience. Only if she develops acute pain related to GI effects
of the drug would this be appropriate. If GI symptoms develop it may lead to imbalanced
nutrition, but that remains to be seen. No indication about constipation exists.
A 3-year-old girl with a diagnosis of spasticity caused by cerebral palsy has been
admitted to the unit. The physician has ordered dantrolene to see if it relieves the
spasticity in the child's arms and hands. The nurse would
schedule this child for what routine screenings?
A)Central nervous system and gastrointestinal (GI) function
B)Respiratory and cardiovascular (CV) function
C)Growth and development D)Renal and hepatic function - ANSWER-Ans:AFeedback:
Children prescribed dantrolene should be routinely and regularly screened for central
nervous system and gastrointestinal (including hepatic) toxicity. Growth and
development should be routinely screened in all children. Renal, respiratory, and CV
screening is not indicated.
A 32-year-old female patient is admitted to the floor with a superinfection. Her orders
read tigecycline (Tygacil) 100 mg IV followed by 50 mg IV every 12 hours infused over
, 30 to 60 minutes for 5 days. What would be important for the nurse to educate this
patient about?
A)Analgesics B)Antihistamines C)Contraceptives D)Decongestants - ANSWER-Ans:C
Feedback:
Many antibiotics interfere with the effectiveness of oral contraceptives and unplanned
pregnancies can occur. Women should be advised to use a barrier form of
contraceptives when taking this drug. No known serious drug-drug interactions involve
analgesics, antihistamines, or decongestants.
A 4-year-old is admitted to the emergency department in shock after a motor vehicle
accident. The patient weighs 12.5 kg. What would be the minimum safe dose of
adrenalin if the pediatric dose is 0.005 to 0.01 mg/kg IV?
A)0.0625 mg B)0.075 mg C)0.08 mg D)0.085 mg - ANSWER-Ans:A Feedback:
To calculate the minimum dosage, multiply the child's weight in kg by the lower dosage
range; 12.5 × 0.005 = 0.0625 mg.
A 55-year-old man presents at the clinic complaining of erectile dysfunction. The patient
has a history of diabetes mellitus. The physician orders tadalafil (Cialis) to be taken 1
hour before sexual intercourse. The nurse reviews the patient's history before
instructing the patient on the use of this medication. What disorder (or condition) would
contraindicate the use of tadalafil (Cialis)?
A)Cataracts B)Penile implant C)Hypotension D)Lung cancer - ANSWER-Ans:B
Feedback:
Patients with a penile implant should not take tadalafil. Patients with cataracts,
hypotension, or lung cancer may take tadalafil if needed but
should do so with caution and should be carefully monitored for adverse effects.
A 66-year-old female patient is on long-term oral glucocorticoid therapy to treat chronic
obstructive pulmonary disease. When providing drug teaching, the nurse will inform this
patient that she is at particular risk for what?
A)HyponatremiaB)Spontaneous fractures C)Respiratory depression D)Ineffective
temperature regulation - ANSWER-Ans:BFeedback:
Only spontaneous fractures are considered an adverse effect of glucocorticoids; this
patient would be at increased risk because her age and gender put her at higher risk for
osteoporosis, which also has the adverse effect of spontaneous fractures. Long-term
glucocorticoid therapy is not associated with hyponatremia, respiratory depression, or
ineffective temperature regulation.
A 68-year-old male patient tells the nurse that he has been unable to get an erection for
the past 6 months and he guesses his sex life is over. The provider orders diagnostic
testing to determine whether sildenafil (Viagra) is appropriate for the patient. What is the
most correct nursing diagnosis for this patient?
A)Sexual dysfunctionB)Disturbed body imageC)Ineffective sexuality pattern D)Disturbed
tactile sensory perception - ANSWER-Ans:A
Feedback:
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