Transcript Pharmacology cvs MCQs 2

A nurse is providing instructions to a patient who is receiving Warfarin
sodium (Coumadin). Which statement made by the patient indicates the
need for further instruction ?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (APTT)
C. Haematocrit (Hct)
D. Haemoglobin (Hb)
The answer is B. Activated partial thromboplastin assesses the therapeutic
level of heparin. Option A : Assesses the therapeutic level of warfarin
sodium (Coumadin). Option C and D : Measure the aspect of the red blood
cells
A nurse is caring for a client receiving a heparin intravenous (IV) infusion. The nurse expects
that which of the following laboratory will be prescribed to monitor the therapeutic effect of
heparin?
A.
B.
C.
D.
Prothrombin time (PT)
Activated partial thromboplastin time (APTT)
Hematocrit (Hct)
Hemoglobin (Hb)
The answer is B. Activated partial thromboplastin time assess the therapeutic level of heparin. Option A:
Assess the therapeutic level of warfarin sodium (Coumadin). Options C and D: Measures the aspect of the red
blood cells.
A patient with atrial fibrillation is receiving a continuous heparin infusion at 1,000
units/hr. The nurse observes that the patient is receiving the therapeutic effect base on
which of the following results?
A.
B.
C.
D.
Activated partial thromboplastin time of
Activated partial thromboplastin time of
Activated partial thromboplastin time of
Activated partial thromboplastin time of
30 seconds
60 seconds
120 seconds
15 seconds
The answer is B. The normal range for activated partial thromboplastin time is 20 – 60 seconds. The activated
partial thromboplastin time must be 1.5 to 2.5 times the normal value, the patient’s APPT would be
considered therapeutic if it is 60 seconds
A patient is receiving intravenous heparin therapy. The nurse ensures the availability of
which of the following medication :
A.
B.
C.
D.
Acetylcysteine (Mucomyst)
Calcium gluconate
Vitamin K (Mephyton)
Protamine sulphate
The answer is D. Protamine sulfate is the antidote that reverses the anticoagulant effects of heparin by
binding to it. Option A is the antidote for acetaminophen toxicity. Option B is the antidote for magnesium
sulfate toxicity. Option C is the antidote for warfarin sodium toxicity.
A patient is receiving a continuous infusion of streptokinase (Streptase). The patient
suddenly complains of a difficulty in breathing, itchiness, and nausea. Which of the
following should be the priority action of the nurse?
A.
B.
C.
D.
Stop the infusion and notify the physician.
Administer protamine sulphate and provide oxygen therapy.
Administer antihistamine then continue the infusion.
Slow the infusion and administer oxygen.
The answer is A. Severe allergic reaction to streptokinase requires immediate discontinuation of
Streptokinase,then notify the physician and administer an adrenergic, antihistamine, and/or corticosteroid
agents as ordered.
A patient with deep vein thrombosis is receiving Streptokinase (Streptase). The nurse would
notify the physician if which of the following assessment is noted?
A.
B.
C.
D.
A temperature of 99.2° Fahrenheit
A pulse rate of 99 beats per minute
A respiratory rate of 25 breaths per minute.
A blood pressure of 185/110 mm Hg
The answer is D. Thrombolytic therapy is contraindicated with uncontrolled hypertension (systolic BP >180 mm Hg
and/or diastolic BP >110 mm Hg) because of the risk of cerebral hemorrhage. Options A, B, and C may be present
during the therapy but will not warrant the immediate knowledge of the physician before starting the therapy.
A client who is receiving streptokinase therapy suddenly had a nose bleeding. The nurse
ensures the availability of which of the following medications?
A. Vitamin K (Mephyton).
B. Deferoxamine (Desferal).
C. Aminocaproic acid (Amicar).
D. Diphenhydramine (Benadryl).
The answer is C. Bleeding can be reversed with the use of aminocaproic acid as an antidote for
streptokinase. Option A is the antidote for warfarin sodium toxicity. Option B is the antidote for iron
toxicity. Option D is an antihistamine that can be used for any allergic reaction.
A nurse is providing health teachings regarding antiplatelet medications.Which of the
following is not true regarding the use of this medication?
A.
B.
C.
D.
Antiplatelet medication inhibits the aggreagation of platelets in the clotting
process, thereby prolonging bleeding time
Antiplatelet medications cannot be used with anticoagulants
Take the medication with food to prevent gastrointestinal upset
A routine bleeding time is monitored during the therapy
The answer is B. Antiplatelet and anticoagulant therapies are effective in preventing a
clot from forming and growing. Both are not needed at the same time.
A patient is receiving Procainamide (Procanbid) for the treatment of ventricular
arrhythmia. The patient suddenly complains of nausea and drowsiness. Whiich of the
following interventions should the nurse do first?
A. Check the blood pressure and heart rate
B. Do a 12 lead ECG right away.
C. Measure the heart rate on the rhythm strip.
D. Give hydralazine (Apresoline) per orum
The answer is A. The patient is experiencing signs of a procainamide toxicity. The
priority nursing action is to obtain vital signs immediately. Options B and C are done
after checking the vital signs. Option D will cause hypotension.
A patient with myocardial infarction is receiving tissue plasminogen activator, Alteplase
(Activase, tPA). While on the therapy, the nurse plans to prioritize which of the following
?
A. Observe for neurological changes
B. Monitor for any signs of renal failure
C. Check the food diary
D. Observe for signs of bleeding
The answer is D. Bleeding is a serious concern for a patient who is on thrombolytic
medication.
A Nurse is caring for a patient who is taking digoxin (Lanoxin) 0.25 mg tab once a day. The
patient suddenly complains of anorexia, nausea, vomiting, and diarrhoea. The physician is
diagnosing a digoxin toxicity. As a nurse you know that the therapeutic level of digoxin in the
blood is :
A. 0.25-0.5 ng/ml.
B. 0.5-2 ng/ml.
C. 1.5-3 ng/ml.
D. 3.5-4.5 ng/ml
The answer is D. The therapeutic level of digoxin is 0.5 – 2 ng/mll
A Nurse is monitoring a patient who is taking Carvedilol. Which of the following
assessment made by the nurse would warrant a possible complication with the use of
this medicine?
A.
B.
C.
D.
Baseline blood pressure of 160/100 mm Hg followed by a blood pressure of 120/70
mm Hg after 3 doses.
Baseline heart rate of 97/mt followed by a heart rate of 62/mt after 3 doses
Complaints of nightmares and insomnia
Complaints of dyspnea
The answer is D. Complaints of dyspnea is a sigh of bronchospasm which is one of the serious
complication of beta blockers. Options A and B shows a decrease in the blood pressure and
heart rate which are expected in this therapy. Option C is a side effect of this medication.
A nurse is interviewing a patient who is about to receive metoprolol. Upon the history
takin, the patient is also taking insulin which of the following statements made by the
nurse will correctly explain the possible interaction of these medications?
A.
B.
C.
D.
This medication will maintain the blood sugar level on a normal range
This medication will have no effect in the blood sugar level
This medication may mask some of the symptoms of hypoglycemia such as tremor,
palpitation and rapid heart beat
This medication may mask some of the symptoms of hyperglycemia such as
headache, increased thirst and blurred vision.
The answer is C. Beta-blockers such as metoprolol may increase the risk of hypoglycemia in
patients receiving insulin. In addition, beta-blockers may mask some of the symptoms of
hypoglycemia such as tremors, palpitation, and rapid heart beat, making it more difficult to
recognize an oncoming episode.
A patient is about to receive Metolazone (zaroxolyn). The nurse in charge understands
that which of the following laboratory results are related to the administration of the
medication?
A. Hyperkalemia and hypocalcemia
B. Hyperkalemia and hypoglycemia
C. Hypouricemia and hypoglycemia
D. Hypokalemia and hyperglycemia
The answer is D. Metolazone is a thiazide diuretic that may put patients risk for
hypokalemia, hyperglycemia, hyperlipidemia, hypercalcemia and hyperuricemia.
A patient with congestive heart failure is being treated with Torsemide (Demadex). The nurse
obtains the following vital signs. Blood pressure of 100/65 mm Hg., pulse rate of 91 beats per
minute, and respiration of 25 breaths per minute. Which of the following will be the priority
assessment of the nurse after the initiation of the dose?
A. Urine output
B. Serum potassium and calcium
C. Blood pressure
D. Weight
The answer is C. The priority assessment in this situation will be the monitoring of the
blod pressure because hypotension poses a risk in this medication. Options A, B, and D
are moitored but they are not the priority.
A nurse is giving instruction to a patient who is receiving Cholestyramine (Questran) for
the treatment of hyperlipidemia. Which of the following statements made by the patient
indicates the need for further instructions?
A.
B.
C.
D.
This medication comes in a provider that must be mixed with juice or water before
administration
I will avoid eating foods rich in saturated fats
I will continue taking nicotinic acid as part of the treatment.
Constipation, belching and heartburn are some of the side effects.
The answer is C. A combination of Cholestyramine and nicotinic acid damages the liver.
Options A, B, and D are true regarding this medication.
A nurse is providing instructions to a client who is on nicotinic acid for the treatment of
hyperlipidemia. Which statement made by the nurse indicates a comprehension of the
instructions?
A. I should take aspirin 30 minutes before nicotinic acid
B. I will drink alcohol in moderation
C. Yellowing of the skin is a common side effect
D. This medication is taken on an empty stomach
The answer is A. The use of aspirin or a nonsteroidal anti-inflammatory drug 30 minutes
before decreases flushing which is a side effect of taking nicotinic acid. Option B : Drinking
alcohol will cause liver abnormalities. Option C is a sign of liver dysfunction and should be
immediately informed to the physician. Option D : this medication is taken with meals to
decrease gastrointestinal upset
A nurse is monitoring a patient who is taking Digoxin (Lanoxin). All the following are the
side effects of digoxin except :
A. Anorexia
B. Blurred vision
C. Diarrhoea
D. Tremors
The answer is D. Signs of digoxin toxicity are as follows : anorexia, nausea, vomiting,
diarrhea, and blurred vision. But tremors do not occur.
A nurse is interviewing a patient who is about to receive bumetanide (Bumex). Which of
the following is a concern related to the administration of the medication?
A. Penicillin allergy
B. Sulfa allergy
C. Soy content allergy
D. Cephalosporin allergy
The answer is B. Loop diuretics such as bumetanide are sulfa-based medications. A
patient with sulfa allergy is at risk for an allergic reaction
A patient arrives in the emergency with complaints of chest pain, and is diagnosed with
acute MI. a morphine 4 mg IV was given 5 minutes ago. Which of the following
assessment made by the nurse indicates a further immediate action?
A. Respiratory rate from 29/mt to 12/mt
B. Blood pressure from 120/70 to 100/60 mmHg
C. The patient still complains of chest pain with a pain scale of 2/10
D. Cardiac rate of 103/mt and a normal sinus rhythm of the ECG.
The answer is C. The goal for the patient with an acute myocardial infarction is to eliminate
the pain. Even pain related at a level of 2/10 should be managed with an additional dose of
morphine. Options A, B and d , although hypotension, respiratory depression and tachycardia
are the side effects of morphine but they do not require further action at this time.