Nursing Pharmacology Final Exam at Fox Valley Technical College
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Free Nursing Pharmacology Final Exam at Fox Valley Technical College Questions
A client has been using fluticasone (Flovent) for his asthma. He returns to the health care provider's office because he has a sore mouth. Assessment reveals white patches in the client's tongue. What is the best explanation for this?
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The client has been consuming hot beverages after the use of the inhaler, which irritated his throat.
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The client has limited his fluid intake, resulting in a dry mouth and tongue.
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The white patches are just the residue of the inhaler propellant that is coating the inside of his mouth.
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The client likely has developed thrush because he is not rinsing effectively after using the inhaler.
Explanation
Explanation of Correct Answer:
D. The client likely has developed thrush because he is not rinsing effectively after using the inhaler.
Fluticasone (Flovent) is an inhaled corticosteroid used for asthma. One common side effect of inhaled corticosteroids is the development of oral thrush (candidiasis), which is a fungal infection in the mouth characterized by white patches on the tongue and inside of the cheeks. This happens because corticosteroids can alter the normal balance of microorganisms in the mouth, allowing fungi like Candida to grow. Rinsing the mouth after using the inhaler helps to prevent this side effect by removing residual medication and reducing the risk of thrush.
Correct Answer Is:
D. The client likely has developed thrush because he is not rinsing effectively after using the inhaler.The mechanism of action for cephalosporins is to disrupt the bacterial cell wall. What other antimicrobial drug class has a similar mechanism of action and may have cross sensitivity with cephalosporins?
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Penicillin
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Fluoroquinolones
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Aminoglycosides
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Sulfonamides
Explanation
Explanation of Correct Answer:
Cephalosporins and penicillins both belong to the beta-lactam class of antibiotics, which work by disrupting the bacterial cell wall. Due to their structural similarities, there is a potential for cross-sensitivity between these two drug classes, meaning that patients who are allergic to penicillin may also have an allergic reaction to cephalosporins.
Correct Answer Is:
A. PenicillinCalcitonin and bisphosphonates, like alendronate, are used to treat which disease?
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Osteoarthritis
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Osteoporosis
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Rheumatoid arthritis
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Gastroesophageal reflux disease (GERD)
Explanation
Calcitonin and bisphosphonates such as alendronate are used to treat osteoporosis because they help reduce bone loss and increase bone density. Bisphosphonates inhibit osteoclast activity, slowing bone resorption, while calcitonin helps regulate calcium levels and also decreases bone breakdown. These actions lower the risk of fractures in clients with weakened bones.
Correct Answer Is:
B. OsteoporosisA client has been diagnosed with gout. Which medication would be appropriate to treat this client?
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adalimumab (Humira)
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probenecid (Benacar)
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allopurinol (Zyloprim)
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levothyroxine (Synthroid)
Explanation
Allopurinol is a xanthine oxidase inhibitor used in the long-term management of gout. It works by decreasing the production of uric acid, which helps prevent recurrent gout attacks and reduces uric acid levels in the blood. This medication is used for chronic gout management, not for acute flare relief, and is appropriate once the diagnosis of gout is established.
Correct Answer Is:
C. allopurinol (Zyloprim)A patient is about to start taking sustained-release glipizide to treat type 2 diabetes mellitus. Which of the following administration instructions should be provided?
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Chew the tablet completely before swallowing
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Take it once a day, 30 minutes before selected meal.
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Take it in the evening before bedtime on an empty stomach
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Must drink 20 oz. water with the medication
Explanation
Glipizide is a sulfonylurea that stimulates insulin release from the pancreas. Sustained-release glipizide should be taken once daily before a meal, usually breakfast, to reduce the risk of hypoglycemia and to ensure proper blood glucose control around food intake. The tablet must be swallowed whole and timed with meals because insulin release increases, and taking it without food can lead to low blood sugar.
Correct Answer Is:
B. Take it once a day, 30 minutes before selected meal.A client is about to start taking somatotropin (growth hormone). How does the nurse plan to evaluate the effectiveness of this drug therapy?
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Level of consciousness
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Electrocardiogram (ECG)
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Height and weight
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Breath sounds and respiratory rate
Explanation
Somatotropin is growth hormone replacement therapy used to promote normal growth and development. The primary indicators of effectiveness are increases in height and appropriate weight gain over time, especially in pediatric clients. These measurements directly reflect the hormone’s role in stimulating bone growth, muscle development, and overall physical growth, making them the most accurate and relevant parameters to monitor.
Correct Answer Is:
C. Height and weightA client with Parkinson's Disease is prescribed benztropine (Cogentin), an anticholinergic medication structurally similar to Atropine. Which adverse drug effect limits the usefulness of anticholinergic agents?
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Urinary retention
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Hypotension
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Bradycardia
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Increased salivation
Explanation
Anticholinergic medications, like benztropine, block the action of acetylcholine, which can lead to several adverse effects. One significant side effect is urinary retention, as these medications can decrease bladder contractility, leading to difficulty urinating. This side effect limits the usefulness of anticholinergics, particularly in patients who are prone to urinary retention, as it can worsen their symptoms.
Correct Answer Is:
A. Urinary retentionAn elderly client in long-term care is taking a prostaglandin eye drop that changed the color of her iris to a darker color. Which condition does the nurse anticipate the client would have?
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Glaucoma
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Conjunctivitis
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Macular degeneration
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Cataracts
Explanation
Prostaglandin analogs, like latanoprost (Xalatan) and bimatoprost (Lumigan), are commonly used to treat glaucoma by reducing intraocular pressure. One of the side effects of these medications is iris hyperpigmentation, which can cause the iris to darken over time. This side effect is more noticeable in patients with lighter-colored eyes. Since prostaglandins are used to treat glaucoma, the nurse can anticipate this condition in the client.
Correct Answer Is:
A. GlaucomaA client is being discharged home on oxycodone for control of severe pain following surgery. Which education should the nurse provide to the client and their spouse? (Select 5 that apply)
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Slow position change
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Increase fiber and fluid intake
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Take acetaminophen for breakthrough pain
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Avoid driving or operating machinery
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Monitor signs for increased respiratory rate and elevated blood pressure
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Taper medication slowly
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Avoid foods high in sodium
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Take with food to reduce nausea
Explanation
Explanation of Correct Answers:
A. Slow position change
Oxycodone can cause orthostatic hypotension and dizziness. Changing positions slowly helps prevent lightheadedness and reduces the risk of falls, especially during the early phase of opioid therapy.
B. Increase fiber and fluid intake
Opioids commonly cause constipation by slowing gastrointestinal motility. Increasing dietary fiber and fluid intake helps prevent opioid-induced constipation and supports normal bowel function.
D. Avoid driving or operating machinery
Oxycodone can cause sedation, dizziness, and impaired judgment. Clients should avoid driving or operating heavy machinery until they know how the medication affects them.
F. Taper medication slowly
Abrupt discontinuation of opioids can cause withdrawal symptoms. Gradually tapering the medication under provider guidance helps prevent withdrawal and promotes safe discontinuation.
H. Take with food to reduce nausea
Nausea is a common side effect of opioids. Taking oxycodone with food can help minimize gastrointestinal discomfort and improve medication tolerance.
Correct Answer Is:
A. Slow position changeB. Increase fiber and fluid intake
D. Avoid driving or operating machinery
F. Taper medication slowly
H. Take with food to reduce nausea
The provider orders a parenteral dose of steroids for the client with an acute exacerbation of chronic obstructive pulmonary disease (COPD). The nurse recognizes and monitors for which of the following adverse effects of steroids? (Select 4 that apply)
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Hyperglycemia
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Red Man's syndrome
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Increased risk for infection
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Decreased HDL levels
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Behavioral changes
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Fluid retention and weight gain
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Hypotension
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Decreased appetite
Explanation
Explanation of Correct Answers:
A. Hyperglycemia
Steroids, especially when administered for longer periods or in high doses, can increase blood sugar levels, leading to hyperglycemia. This occurs because steroids can induce insulin resistance, affecting the body's ability to regulate blood sugar.
C. Increased risk for infection
Steroids suppress the immune system, which can lead to an increased risk for infections. This is especially important for clients on long-term or high-dose steroid therapy, as their ability to fight off infections is reduced.
D. Decreased HDL levels
Steroids can lead to a decrease in HDL (high-density lipoprotein), which is known as "good cholesterol." A reduction in HDL levels increases the risk for cardiovascular issues, especially with long-term steroid use.
F. Fluid retention and weight gain
Steroids promote fluid retention by causing the kidneys to retain sodium and water. This can lead to weight gain due to increased fluid volume, contributing to edema, particularly in the lower extremities.
Correct Answer Is:
A. HyperglycemiaC. Increased risk for infection
D. Decreased HDL levels
F. Fluid retention and weight gain
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