Nursing Pharmacology Final Exam at Fox Valley Technical College
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Free Nursing Pharmacology Final Exam at Fox Valley Technical College Questions
The average daily dose of enalapril is 5mg and for captopril it is 12 mg. From this information, what can the nurse conclude about these ACE inhibitors?
- Enalapril is twice as effective as captopril.
- Enalapril will likely produce fewer side effects than captopril.
- Enalapril is more potent than captopril.
- The onset of action for captopril will be longer.
Explanation
The potency of a medication is determined by the dose required to produce the desired therapeutic effect. In this case, enalapril has a lower average daily dose (5 mg) compared to captopril (12 mg), which indicates that enalapril is more potent. This means that a smaller dose of enalapril is required to achieve the same effect as a larger dose of captopril, reflecting enalapril's higher potency.
Correct Answer Is:
C. Enalapril is more potent than captopril.A female patient is prescribed atorvastatin (Lipitor). Which of the following statements made by the client indicates patient understanding? (Select 4 that apply)
- "I will have to get my liver function checked again in about three to six months."
- "I will have to monitor my blood pressure daily with this medication."
- "I have to take this medication early in the morning to make it work effectively."
- "I should contact my doctor if I start to have muscle pain."
- "I will avoid eating grapefruit or drinking grapefruit juice."
- "I do not need to adjust my diet since this medication is fixing my cholesterol."
- "I think my cholesterol levels are better now since I feel completely fine."
- "I will let my provider know if I plan to become pregnant."
Explanation
Explanation of Correct Answers:
A. "I will have to get my liver function checked again in about three to six months."
Atorvastatin can cause liver toxicity in some patients, so it's essential to monitor liver function tests periodically, usually every 3 to 6 months during treatment.
D. "I should contact my doctor if I start to have muscle pain."
Muscle pain or weakness can be a sign of rhabdomyolysis, a rare but serious side effect of statins like atorvastatin. Patients should report any muscle discomfort to their doctor immediately.
E. "I will avoid eating grapefruit or drinking grapefruit juice."
Grapefruit can increase the levels of atorvastatin in the blood by inhibiting the enzyme responsible for metabolizing the drug. This can increase the risk of side effects, such as muscle pain and liver damage.
H. "I will let my provider know if I plan to become pregnant."
Atorvastatin is contraindicated during pregnancy due to potential risks to the fetus. It's essential to inform the provider if planning to become pregnant to switch to a safer medication.
Correct Answer Is:
A. "I will have to get my liver function checked again in about three to six months."D. "I should contact my doctor if I start to have muscle pain."
E. "I will avoid eating grapefruit or drinking grapefruit juice."
H. "I will let my provider know if I plan to become pregnant."
Steroids can be used for many different medical issues to help reduce inflammation. Which of the following are not correct uses for steroids? (Select 4 that apply)
- Fluticasone nasal spray for allergic rhinitis
- Prednisone for acute unrelieved low back pain
- Hydrocortisone to treat Addison's disease
- Methylprednisolone to treat a client with asthma attack in the emergency room
- Prednisone oral med to treat type 1 diabetes
- Fludrocortisone to treat Cushing's disease
- Dexamethasone for hypothyroidism
- Betamethasone for osteoporosis treatment
Explanation
Explanation of Correct Answers:
B. Prednisone for acute unrelieved low back pain
While prednisone may be used for acute inflammation in some cases, it is generally not recommended for routine management of acute low back pain unless there is evidence of inflammation, such as in conditions like sciatica. Long-term use of steroids for musculoskeletal pain is discouraged due to potential side effects like osteoporosis and muscle weakness.
E. Prednisone oral med to treat type 1 diabetes
Prednisone is a steroid that can raise blood sugar levels and is not used to treat type 1 diabetes. In fact, it may worsen diabetes management by causing hyperglycemia, so it should be avoided unless absolutely necessary, and blood glucose should be closely monitored.
F. Fludrocortisone to treat Cushing's disease
Fludrocortisone is a mineralocorticoid that is used primarily for conditions like Addison's disease, where it helps retain salt and water. It is not used to treat Cushing's disease, which is characterized by excess cortisol. Treatment for Cushing's disease typically involves reducing cortisol levels, not increasing mineralocorticoid activity.
G. Dexamethasone for hypothyroidism
Dexamethasone is a corticosteroid used for conditions such as inflammation and immune suppression, but it is not used to treat hypothyroidism, which is a thyroid disorder. Hypothyroidism is treated with levothyroxine, a synthetic thyroid hormone.
Correct Answer Is:
B. Prednisone for acute unrelieved low back painE. Prednisone oral med to treat type 1 diabetes
F. Fludrocortisone to treat Cushing's disease
G. Dexamethasone for hypothyroidism
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?
- Penicillin
- Fluoroquinolones
- Aminoglycosides
- 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. PenicillinA 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?
- The client has been consuming hot beverages after the use of the inhaler, which irritated his throat.
- The client has limited his fluid intake, resulting in a dry mouth and tongue.
- The white patches are just the residue of the inhaler propellant that is coating the inside of his mouth.
- 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 client is taking sucralfate for a peptic ulcer. The nurse instructs the client about the therapeutic actions of sucralfate explaining that this drug promotes ulcer healing by which of the following actions?
- Increases gastric pH
- Interacts with gastric acid and creates a protective barrier in the stomach.
- Inhibits the proton pump, decreasing gastric acid.
- Neutralizes gastric acid by blocking histamine.
Explanation
Sucralfate works by interacting with gastric acid and forming a viscous protective barrier over the ulcerated area of the stomach lining. This barrier protects the ulcer from further damage due to gastric acid, promoting healing. It does not directly affect gastric acid secretion but rather acts locally to protect the ulcer site from acidic damage.
Correct Answer Is:
B. Interacts with gastric acid and creates a protective barrier in the stomach.Which of the following statements are true regarding antipsychotic drugs? (Select 4 that apply.)
- Antipsychotic drugs reverse mental illness
- Antipsychotic drugs may cause neuroleptic malignant hyperthermia
- Many symptoms of psychosis, like hallucinations, can be controlled with medication
- Almost all clients are compliant with medications
- Antipsychotic drugs may cause extrapyramidal symptoms
- Antipsychotic drugs work by blocking dopamine receptors in the brain
- Antipsychotic drugs may cause Cushing's disease
- Antipsychotic drugs are reversed by Acetylcysteine
Explanation
Explanation of Correct Answers:
B. Antipsychotic drugs may cause neuroleptic malignant hyperthermia
Neuroleptic malignant hyperthermia (NMS) is a rare but life-threatening condition that can occur with the use of antipsychotic medications. It is characterized by fever, muscle rigidity, and autonomic dysregulation. Immediate intervention is required if NMS is suspected.
C. Many symptoms of psychosis, like hallucinations, can be controlled with medication
Antipsychotic medications are effective in controlling symptoms of psychosis, including hallucinations, delusions, and disorganized thinking. These medications help manage these symptoms by modulating neurotransmitter activity, particularly dopamine.
E. Antipsychotic drugs may cause extrapyramidal symptoms
Extrapyramidal symptoms (EPS) include movement disorders like tremors, rigidity, bradykinesia, and tardive dyskinesia. These side effects can occur with antipsychotic medications, especially older first-generation antipsychotics.
F. Antipsychotic drugs work by blocking dopamine receptors in the brain
Antipsychotics primarily work by blocking dopamine receptors (D2 receptors) in the brain. This action helps to control dopaminergic overactivity, which is thought to contribute to the symptoms of psychosis, such as hallucinations and delusions.
Correct Answer Is:
B. Antipsychotic drugs may cause neuroleptic malignant hyperthermiaC. Many symptoms of psychosis, like hallucinations, can be controlled with medication
E. Antipsychotic drugs may cause extrapyramidal symptoms
F. Antipsychotic drugs work by blocking dopamine receptors in the brain
A client presents to the hospital with an anaphylactic reaction following a bee sting. The ER provider prescribed 50mg of IV diphenhydramine and 1 mg IV epinephrine STAT. Following the administration of the Epinephrine (a sympathomimetic drug), the nurse would assess for which of the following adverse drug effects?
- Nausea, increased urinary output, and low heart rate
- Insomnia, increased heart rate, and increased blood pressure
- Diarrhea, drowsiness, and dyspnea
- Shakiness, decreased blood pressure, and malaise
Explanation
Epinephrine is a sympathomimetic drug, meaning it stimulates the sympathetic nervous system, leading to effects such as increased heart rate, increased blood pressure, and insomnia. These are expected and common side effects following the administration of epinephrine, as it activates the adrenergic receptors (alpha and beta receptors) to counteract the effects of anaphylaxis, like airway constriction and hypotension.
Correct Answer Is:
B. Insomnia, increased heart rate, and increased blood pressureA teenage client is taking duloxetine (Cymbalta) for depression. The dose has been increased by the provider. The nurse advises the client and the family to watch for which adverse effect?
- Thrush
- Irritability
- Warning signs of suicide
Explanation
Duloxetine (Cymbalta), like other antidepressants, can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults, especially after dose adjustments. It is crucial to closely monitor the teenage client for any warning signs of suicide, including talking about death, withdrawing from activities, or displaying significant mood swings. These symptoms require immediate intervention and consultation with the healthcare provider.
Correct Answer Is:
C. Warning signs of suicideWho is the client's last line of defense in preventing medication errors in the acute care and long-term care setting?
- Pharmacist
- Health Care Provider
- Nurse
- Pharmacy technician
Explanation
The nurse is the final professional to assess, administer, and evaluate medications before they reach the client. This role includes verifying the five rights of medication administration, assessing the client for contraindications, allergies, and current status, clarifying unclear orders, and monitoring for adverse effects after administration. Because the nurse directly administers medications and observes the client’s response, they serve as the last safeguard against medication errors.
Correct Answer Is:
C. NurseHow to Order
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