NUR 2407 PHARMACHOLOGYEXAM 2 (3 NEWEST VERSIONS) VERSION A, B AND C NEWEST 2024 EACH VERSION CONTAINS 200 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+

NUR 2407 PHARMACHOLOGYEXAM 2 (3
NEWEST VERSIONS) VERSION A, B AND
C NEWEST 2024 EACH VERSION
CONTAINS 200 QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+
Caution should be used when giving which of the following patients high doses of
prednisone? patient with...
a. rheumatoid arthritis
b. diabetes
c. asthma
d. systemic lupus - ANSWER-b
Prednisone, a corticosteroid, causes increased blood glucoselevels. For diabetic
patients, this can be severe enough to induce severe (ie:symptomatic) hyperglycemia
and sometimes even diabetic ketoacidosis.
Which drug is used to reduce the risk of maternal to fetaltransmission of HIV?
a. enfuvirtide
b. zidovudine
c. indinavir
d. ritonavir - ANSWER-b
Zidovudine is a nucleoside/nucleotide reverse transcriptaseinhibitor (NRTI), which is
typically added to a protease inhibitor to furtherreduce maternal-fetal transmission of
HIV; NRTIs have a better safetyprofile than other options to reduce perinatal HIV
transmission.
which of the following is true of IV iron dextran?
a. it can cause significant diarrhea
b. epinephrine should be at the bedside
c. observe patient 3hrs after test dose before proceeding with the rest o fthe dose
d. antacids can decrease the absorption - ANSWER-b
Anaphylaxis is common; epinephrine reverses anaphylacticreactions. Typically the test
dose observation period is 1 hour, not 3.
(c and d are hallmarks of oral iron supplements)
A febrile neutropenic patient is admitted with a very lowblood pressure of 90/60.
Pneumonia is suspected. Ordershave been received to obtain stat sputum and
bloodcultures and to start a broad spectrum antibiotic whileawaiting culture results. The
nurse will complete theorders in which sequence?
A. Question the antibiotic order and obtain cultures
B. Sputum culture, antibiotic dose, blood culture
C. Antibiotic dose, sputum culture, blood culture
D. Sputum culture, blood culture, antibiotic dose - ANSWER-d
Always culture first, give antibiotics doses after. While antibioticsdo not take effect
immediately, we obtain cultures first to ensure the resultsare not altered by antibiotic
administration. Antibiotics should not bedelayed for cultures however, particularly in a
patient with fever (sign ofactive infection), neutropenia (form of immunocompromise),
and who ishypotensive (sign of sepsis).
A patient has an order for gentamicin to be administered q12 hours via IV over 30
minutes. The patient has been onthe medication for several days and the physician
hasordered a trough serum antibiotic level. It is 0930 and thenurse has just completed
infusing the 0900 dose. At whattime should the nurse expect the trough levels to be
drawn?
a. 2030
b. 1930
c. immediately
d. 1000 - ANSWER-a
Trough = when the medication is at its lowest serumconcentration, ie: right before we
re-dose. 2100 is 12 hours after 0900, so you would expect to draw the trough shortly
before the 2100 dose is due. (30min before)
A patient who takes multiple antibiotics starts to experience diarrheal stools. The nurse
anticipates administration of which antibiotic if a stool sample testspositive for
Clostridium difficile given that the patientalready had a prior Clostridium difficile
infection?
a. clindamycin
b. oral vancomycin
c. trimethoprim/sulfamethoxazole
d. penicillin - ANSWER-b
Oral vancomycin, of the medications listed, is the onlymedication that has action against
C. diff. Clindamycin is commonlyassociated with C. diff superinfection, so it would not
make sense totreat C. diff with an agent well known for creating conditions where C.diff
can propagate.
A nurse is providing client education to a client who hashad hydrocortisone prescribed.
What drug should thenurse teach the client to avoid while taking the hydrocortisone?
a. allergy medicine
b. levothyroxine
c. aspirin
d. metformin - ANSWER-c
One of the side-effects of corticosteroids is pepticulcers...which is also a side-effect of
aspirin. The same issue istrue of NSAID use (ie: ibuprofen, naproxen, etc.), as peptic
ulcerscan cause GI bleeding. In practice, one way to counteract this isshort-term use of
an H2 blocker (e.g., famotidine/Pepcid).
A patient taking pyrazinamide as part of their treatmentprotocol for TB reports anorexia,
fatigue, dark coloredurine, and malaise. The nurse should recognize the signsand
symptoms as being consistent with
a. hepatotoxicity
b. hyperuricemia
c. peripheral neuropathy
d. nephrotoxicity - ANSWER-a
First: TB drugs are all hepatotoxic - when you see adverse effectsof TB drugs, think
hepatotoxicity first.Second: Fatigue, poor appetite, and dark urine can be signs of liver
issues.The liver creates enzymes that help break down fats and some proteins; whenit
is not working well, it is harder for your body to break these compoundsdown. Fatigue is
sometimes secondary to a mild acidosis due to suboptimalmetabolism of cell waste
products, and acidosis makes it harder for the cellsto function optimally. Dark colored
urine is often dark in color because ofbilirubin spillover into the urine; it's an orangeyellow-brown sort of colorwhen you see it.
Which drug is used for prophylactic treatment after TB exposure?
a. pyrazinamide
b. isoniazid
c. rifampin
d. ethambutol - ANSWER-b
All of these drugs are given for tuberculosis treatment...butonly isoniazid is an effective
prophylactic
Indinavir is prescribed for a patient newly diagnosed withHIV. Due to the side effects of
this drug, which of thefollowing patients need the closest monitoring? Thosewith a
health history of
a. pulmonary fibrosis
b. cardiac arrhythmias
c. diabetes and high serum cholesterol
d. kidney disease and gout - ANSWER-c
When you see HIV meds, monitoring almost alwaysincludes liver function and
cholesterol levels. Hypertriglyceridemiais extremely common in diabetic patients,
especially type 2.
The nurse is providing care for a client who has beentaking fludrocortisone for the
treatment of hypotension. What assessment finding would suggest that the client
isexperiencing adverse effects?
a. the client's potassium level is above normal
b. the patient is dizzy and their BP is down
c. the client has been having fequent, loose bowel movements
d. the client has fine crackes on lung ausculation - ANSWER-d
One of the side-effects of mineralcorticoids (andcorticosteroids in general) is fluid
retention. Crackles can beheard when fluid retention effects the lungs.
A patient with a history of inflammatory bowel disease isprescribed insulin and acarbose
for the treatment of highpostprandial glucose levels. Which nursing action is apriority in
this case?
a. consult the provider before administering acarbose
b. administer insulin and acarbose simultaneously
c. assess the patient's weight before administering the acarbose
d. ask the patient about allergic rxns to any drugs - ANSWER-a
Acarbose's mechanism of action is to slow the digestionof carbohydrates in the GI tract.
However, our GI flora like to eatcarbohydrates. Slowing digestion of carbohydrates
gives the GI floramore opportunity to eat and reproduce in a bacteria food-richenvironment, which can cause increased bowel inflammation especially in patients who
already have inflammatory bowel disease.
Which of the following assessments would take priority ina patient receiving Epoetin
Alfa?
a. lung sounds
b. liver functino tests
c. blood pressure
d. temperature - ANSWER-c
Erythropoietin is a cytokine, specifically one thatstimulates RBC production. Some
cytokines increase sympatheticactivity, which increases blood pressure and
thrombosis.Accordingly, hypertension and increased risk of blood clots havebeen
observed in patients receiving epotin alfa.
It would be of greatest priority to consult the prescriber of enfuvirtide if the patient
experienced
a. an increasing CD4 count
b. headache
c. pain and tenderness at injection site
d. weakness and tingling in extremities - ANSWER-d
Gullian-Barre is a rare autoimmune-mediated neurologic side-effectof numerous
medications, including enfuvirtide. Gullian-Barre is an ascendingparalysis that starts in
the extremities and is caused by autoimmune damage tothe peripheral nervous tissue
(several tissues have been noted as autoimmunetargets; usually the myelin sheaths).
Weakness and tingling in the extremities isthe earliest sign of Gullian-Barre
the nurse is teaching the parent of a young child about administering ferrous sulfate to
the child at home. which teaching point should receive the highest priority?
a. give liquid iron with a straw to reduce tooth staining
b. store ferrous sulfate in a childproof container and keep it out of the child's reach
c. this medicine may cause the child's stool to look dark green or black
d. don't give iron with any other meds or vitamins - ANSWER-b
(death from overdose of iron-containing products is leading cause of poisoning fatalities
in US)
A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is
teaching hypoglycemia awareness and should warn the patient about the presence of
which symptom?
a. vomiting
b. muscle cramps
c. tachycardia
d. chills - ANSWER-c (which is a s/s of hypoglycemia and tachycardia is the most
common A/E of glipizide, which is a sulfonylurea)
Before administering metformin [Glucophage], the nurse should notify the prescriber
about which laboratory value?
a. Creatinine (Cr) level of 2.1 mg/d
b. Hemoglobin (Hgb) level of 9.5 gm/dL
c. Sodium (Na) level of 131 mEq/dL
d. Platelet count of 120,000/mm3 - ANSWER-a
A nurse caring for a patient who has diabetic ketoacidosis recognizes which
characteristics in the patient? (Select all that apply.)
type 2 diabetes
altered fat metabolism leading to ketones
arterial blood pH of 7.35-7.45
sudden onset, triggered by acute illness
plasma osmolaity of 300 to 320 mOsmo/L - ANSWER-altered fat metabolism leading to
ketones, sudden onset, triggered by acute illness, plasma osmolaity of 300 to 320
mOsmo/L
After 3 weeks of therapy with oral ferrous sulfate, a patient calls the clinic nurse,
complaining of continuous nausea and vomiting with this drug. Which is the most
appropriate response to this patient?
a. this may indicate a serious adverse effect of this drug. you need to come into the
clinic
b. try to take your meds with meals. this should reduce your n/v
c. you may need a lower dose, i will contact your primary healthcare provider and call
you back
d. try taking an antacid just before taking your med. this can help reduce stomach acid,
which causes nausea - ANSWER-c (n/v are adverse effects of ferrous sulfate, early in tx
they can take with food to reduce nausea but it significantly reduces absorption so if
these s/s persist, may need to decrease dosage to help mititgate GI effects; drug
shouldn't be taken with a