NUA 285 Pharmacotherapeutics at Georgian Court University
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Free NUA 285 Pharmacotherapeutics at Georgian Court University Questions
Nonselective beta blockers such as propranolol (Inderal) are contraindicated in clients with which of the following? (Select all that apply.)
- A. Asthma
- B. Hypotension
- C. Constipation
- D. Coronary artery disease
- E. Hypertension
Explanation
A. Asthma; B. Hypotension
Explanation
A. Asthma
Nonselective beta blockers block both β₁ and β₂ receptors. Blocking β₂ receptors in the lungs can cause bronchoconstriction, worsening asthma or other respiratory conditions. For this reason, nonselective beta blockers like propranolol are contraindicated in patients with asthma or chronic obstructive pulmonary disease (COPD).
B. Hypotension
Because beta blockers reduce heart rate and cardiac output, they can further lower blood pressure. In patients with existing hypotension, propranolol may cause dangerous drops in blood pressure, dizziness, fainting, or even shock.
A patient who has pain with urination associated with cystitis will be discharged home with a prescription for phenazopyridine (Pyridium). What instruction will the nurse include when teaching the patient about this drug?
- A. "Report reddish-brown urine to the provider immediately."
- B. "The drug provides symptomatic relief of pain."
- C. "Do not take this drug concurrently with an antibiotic."
- D. "This drug has antiseptic and analgesic properties."
Explanation
B. "The drug provides symptomatic relief of pain."
Explanation
Phenazopyridine (Pyridium) is a urinary tract analgesic used to relieve pain, burning, urgency, and discomfort caused by irritation of the urinary tract mucosa, commonly seen in cystitis. It does not treat the infection itself—antibiotics are required for that purpose—but it provides symptomatic relief until the infection resolves. The nurse should inform the patient that reddish-orange or reddish-brown urine discoloration is a normal, harmless side effect, not something to report as an emergency. Patients should also take the drug after meals to reduce gastrointestinal discomfort and use it only for short-term relief (typically 1–2 days) while antibiotic therapy takes effect.
The nurse provides teaching for a patient who will begin taking montelukast sodium (Singulair). Which statement by the patient indicates a need for further teaching?
- A. "I will use this as needed for acute symptoms."
- B. "I will need to have periodic laboratory tests while taking this medication."
- C. "I will take one tablet daily at bedtime."
- D. "I will begin participating in a smoking cessation program at work."
Explanation
A. "I will use this as needed for acute symptoms."
Explanation
Montelukast (Singulair) is a leukotriene receptor antagonist used for the prevention and long-term management of asthma and to relieve symptoms of allergic rhinitis. It is not a rescue medication and should not be used to treat acute asthma attacks or sudden bronchospasm. The patient’s statement indicates a misunderstanding that requires correction. Montelukast is taken once daily, typically in the evening, and helps prevent airway inflammation and bronchoconstriction over time. Patients may also need periodic liver function tests, and smoking cessation further supports respiratory health and asthma control.
Dopamine agonists can be used as a first-line treatment for Parkinson’s disease. Which statement best explains their purpose?
- A. They increase dopamine production in the adrenal glands.
- B. They mimic dopamine’s effects in the brain to improve motor symptoms.
- C. They permanently restore dopamine-producing neurons.
- D. They prevent acetylcholine release in the peripheral nervous system.
Explanation
B. They mimic dopamine’s effects in the brain to improve motor symptoms
Explanation
Dopamine agonists act by stimulating dopamine receptors in the brain, mimicking the action of natural dopamine. This helps reduce hallmark symptoms of Parkinson’s disease such as tremors, rigidity, and bradykinesia. They are often used as a first-line treatment in younger patients or as an adjunct to levodopa to delay motor complications. Unlike levodopa, dopamine agonists do not rely on neuronal dopamine production and have a longer duration of action.
A nurse is monitoring a client who received epinephrine for angioedema after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine?
- A. Client reports decreased groin pain of 3 on a 1 to 10 scale.
- B. The client tolerates a second dose of medication with no greater than 1+ peripheral edema.
- C. The client’s blood pressure when arising from resting position is at premedication levels.
- D. Respirations are unlabored.
Explanation
D. Respirations are unlabored.
Explanation
Epinephrine is administered during angioedema to counteract severe allergic reactions that cause airway swelling and respiratory distress. A therapeutic response is demonstrated by improved airway patency, reduced swelling, and unlabored respirations, indicating that the airway obstruction has resolved. The nurse should continue to monitor oxygen saturation, respiratory rate, and breath sounds. Other options, such as pain relief or changes in peripheral edema, are unrelated to the effectiveness of epinephrine in reversing life-threatening airway compromise.
What is the primary therapeutic use of Brilinta (ticagrelor)?
- A. To treat hyperlipidemia
- B. To prevent thrombotic events in patients with acute coronary syndrome
- C. To manage hypertension
- D. As a first-line treatment for heart failure
Explanation
B. To prevent thrombotic events in patients with acute coronary syndrome
Explanation
Brilinta (ticagrelor) is an antiplatelet medication that works by inhibiting the P2Y12 ADP receptor on platelets, preventing their activation and aggregation. Its primary therapeutic use is to reduce the risk of thrombotic cardiovascular events, such as myocardial infarction (MI), stroke, or stent thrombosis, in patients with acute coronary syndrome (ACS) or those who have undergone percutaneous coronary intervention (PCI) with stent placement. Ticagrelor is often prescribed in combination with aspirin for dual antiplatelet therapy. It is not used to treat hypertension, heart failure, or hyperlipidemia. The nurse should educate the patient about the risk of bleeding and the importance of not discontinuing the medication without consulting the provider.
The nurse is preparing to administer ciprofloxacin (Cipro) to a client. Which of the following administration guidelines should the nurse provide to the client? (Select all that apply.)
- A. Take ciprofloxacin on an empty stomach for best absorption.
- B. Avoid prolonged sun exposure while taking ciprofloxacin.
- C. Take ciprofloxacin with a full glass of water.
- D. Avoid taking ciprofloxacin with dairy products.
- E. Ensure adequate fluid intake while taking ciprofloxacin.
Explanation
B. Avoid prolonged sun exposure while taking ciprofloxacin; C. Take ciprofloxacin with a full glass of water; D. Avoid taking ciprofloxacin with dairy products; E. Ensure adequate fluid intake while taking ciprofloxacin
Explanation
B. Avoid prolonged sun exposure while taking ciprofloxacin
Ciprofloxacin can cause photosensitivity, making the skin more susceptible to sunburn. Clients should avoid direct sunlight, wear protective clothing, and use sunscreen to prevent severe skin reactions.
C. Take ciprofloxacin with a full glass of water
Adequate hydration helps prevent crystalluria and kidney irritation. Taking the medication with a full glass of water ensures proper absorption and reduces gastrointestinal discomfort.
D. Avoid taking ciprofloxacin with dairy products
Dairy products and calcium-fortified juices can bind with ciprofloxacin, reducing its absorption and effectiveness. Clients should take the medication at least 2 hours before or 6 hours after consuming dairy.
E. Ensure adequate fluid intake while taking ciprofloxacin
Maintaining hydration supports kidney function and helps the body eliminate the drug efficiently, minimizing the risk of renal complications and enhancing therapeutic effects.
A 65-year-old female client with a long history of acute coronary syndrome (ACS) had two cardiac stents placed via percutaneous coronary intervention. After this procedure, she was started on aspirin 325 mg orally once daily and clopidogrel 75 mg orally once daily. The nurse is preparing to provide education about each of these drugs. Which of the following health teaching statements are essential for this client? (Select all that apply.)
- A. Report any unexpected bleeding to your primary health care provider.
- B. Continue taking your newly prescribed medications until your prescriber tells you not to do so.
- C. Drink a full glass of water with each dose of your new medications.
- D. Eat foods high in vitamin K and calcium to help prevent clotting.
- E. Avoid taking other medications that can cause bleeding, such as NSAIDs like ibuprofen.
Explanation
A. Report any unexpected bleeding to your primary health care provider; B. Continue taking your newly prescribed medications until your prescriber tells you not to do so; E. Avoid taking other medications that can cause bleeding, such as NSAIDs like ibuprofen.
Explanation
A. Report any unexpected bleeding to your primary health care provider
Aspirin and clopidogrel are antiplatelet agents that increase bleeding risk. The patient should report any unusual bleeding, bruising, or black stools immediately to prevent severe complications.
B. Continue taking your newly prescribed medications until your prescriber tells you not to do so
It is crucial to continue dual antiplatelet therapy to prevent stent thrombosis, which can be life-threatening if treatment is stopped abruptly.
E. Avoid taking other medications that can cause bleeding, such as NSAIDs like ibuprofen
NSAIDs increase the risk of gastrointestinal bleeding when combined with antiplatelets. The patient should check with the healthcare provider before taking any additional over-the-counter medications.
A patient is receiving metoprolol (Lopressor) post–myocardial infarction (MI). The nurse should monitor for which adverse effect?
- A. Constipation and dry mouth
- B. Signs of heart failure such as edema and weight gain
- C. Signs of hyperactivity
- D. Increased energy and appetite
Explanation
B. Signs of heart failure such as edema and weight gain
Explanation
Metoprolol (Lopressor) is a cardioselective beta-1 adrenergic blocker commonly used after a myocardial infarction to reduce cardiac workload, decrease heart rate, and prevent recurrent ischemic events. However, because it reduces myocardial contractility, it can also exacerbate or cause heart failure in some patients. The nurse should monitor for symptoms of heart failure, including peripheral edema, shortness of breath, crackles in the lungs, and rapid weight gain. Other adverse effects may include bradycardia, fatigue, and hypotension, but fluid retention and weight gain are key warning signs requiring provider notification.
A characteristic that is unique to vitamin B12 is that it requires:
- A. An acidic intestinal environment for synthesis
- B. Lipids for absorption
- C. The mineral magnesium for full activity
- D. Intrinsic factor for absorption
Explanation
D. Intrinsic factor for absorption
Explanation
Vitamin B12 (cobalamin) is unique because it requires intrinsic factor, a glycoprotein produced by the parietal cells of the stomach, for proper absorption in the ileum. Without intrinsic factor, vitamin B12 cannot be absorbed, leading to pernicious anemia and neurological complications due to impaired red blood cell formation and myelin synthesis.
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