Pharmacology 2017 Hesi PN Specialty V2

Pharmacology 2017 Hesi PN Specialty V2 1) A client is being treated for hyperthyridism with propylthiouracil

(PTU). The LPN/LVN knows that the action of this drug is to:

• decrease the amount of thyroid stimulating hormone circulating in

the blood.

• increase the amount of thyroid-stimulating hormone circulating in

the blood.

• increase the amount of T4 and decrease the amount of T3 produced

by the thyroid.

• inhibit synthesis of T3 and T4 by the thyroid gland.
• PTU is an adjunct therapy used to control hyperthyroidism by

inhibiting production of thyroid hormones. It is often prescribed in prep for thyroidectomy or radioactive iodine therapy 2) A female client with RA takes ibuprofen (motrin) 600mg PO 4xday.To preven GI bleeding, misoprostol (cytotec) 100mcg PO is prescribed. Which information is most important for the nurse to include in client teaching?

• use contraception during intercourse
• ensure the cytotec is taken on an empty stomach
• encourage oral fluid intake to prevent constipation
• take cytotec 30min prior to motrin
• Use contraception during intercourse.

Cytotec, a synthetic form of prostaglandin, is classified as pregnancy category X and can act as an abortifacient, so the client should be instructed to use contraception during intercourse to prevent loss of early pregnancy 3) Dobutamine (Dobutrex) is an emergency drug most commonly prescribed for a client with which condition?

• Shock.
• Asthma.
• Hypotension.

• Heart failure

D . Heart Failure Dobutamine is a beta-1 adrenergic agonist that is indicated for short term use in cardiac decompensation or heart failure (D) related to reduce d cardiac contractility due to organic heart disease or cardiac surgical procedures. Alpha and beta adrenergic agonists, such as epinephrine a nd dopamine, are sympathomimetics used in the treatment of shock (A).Other selective beta-2 adrenergic agonists, such as terbutaline and isoproterenol, are indicated in the treatment of asthma (B). Although dobutamine improves cardiac output, it is not used to treat hypotension (C).4) Which medications should the nurse caution the client about taking while receiving an opioid analgesic?A . Antacids.

• Benzodiasepines
• Antihypertensives

D . Oral antidiabetics

• B. Benzodiasepines

Respiratory depression increases with the concurrent use of opioid analgesics and other cns depressant agents, such as alcohol, barbiturates, and benzodiasepines 5) Which client should the LPN/LVN identify as being at the highest risk for complications during the use of an opioid analgesic?

• an older client with type 2 diabetes
• A client with chronic rheumatoid arthritis
• A client with a open compound fracture

D . A young adult with inflammatory bowel disease D . A young adult with inflammatory bowel disease 6) Which change in data indicates to the nurse the desired effect of the angiotensin II receptor antagonist valsartan (Diovan) has been achieved A . Dependent edema reduced form +3 to +1

• Serum HDL increased from 35 to 55mg/dl
• PUlse rate reduced from 150 to 90 beats/min

• Blood pressure reduced from 160/90 to 130.80
• D. Blood pressure reduced from 160/90 to 130.80

angiotensin II receptor antagonist (blocker), prescribed from treatment of HTN. The desired effect is a decrease in blood pressure.7) A client with heart failure is prescribed spironolactone (Aldactone).Which information is most important for the LPN/LVN to provide to the client about diet modifications?

• Do not add salt to foods during preparation.
• Refrain for eating foods high in potassium.
• Restrict fluid intake to 1000 ml per day.

D

• Increase intake of milk and milk products.

B.Spironolactone (Aldactone), an aldosterone antagonist, is a potassium- sparing diuretic, so a diet high in potassium should be avoided (B), including potassium salt substitutes, which can lead to hyperkalemia.Although (A) is a common diet modification in heart failure, the risk of hyperkalemia is more important with Aldactone. Restriction of fluids (C) or increasing milk and milk products (D) are not indicated with this prescription.8) The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. What acti on should the nurse implement?A

• Refer the client to an audiologist for evaluation of her hearing.
• Advise the client that this is a common side effect of aspirin

therapy.

• Notify the healthcare provider of this finding immediately.

D

• Ask the client to turn off her hearing aid during the exam.
• Notify the healthcare provider of this finding immediately.

Tinnitus is an early sign of salicylate toxicity. The healthcare provide r should be notified immediately (C), and the medication discontinued. (A and D) are not needed, and (B) is inaccurate.9) The healthcare provider prescribes naproxen (Naproxen) twice daily

for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide?A

• The frequency of the dosing is necessary to increase the

effectiveness.

• Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
• Another type of nonsteroidal antiinflammatory drug may be

indicated.D

• Systemic corticosteroids are the next drugs of choice for pain relief.
• Another type of nonsteroidal antiinflammatory drug may be indicated.

Individual responses to nonsteroidal antiinflammatory drugs are variable , so (C) is the best response. Naproxen is usually prescribed every 8 hours, so (A) is not indicated. The peak for naproxen is one to two hours, not (B). Corticosteroids are not indicated for osteoarthritis (D).10) An older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on whic h pharmacokinetic process?A

• Absorption.
• Metabolism.
• Elimination.

D

• Distribution.

D.A decreased lean body mass in an older adult affects the distribution of drugs (D), which affects the pharmacokinetics of drugs. Decreased gastric pH, delayed gastric emptying, decreased splanchnic blood flow, decreased gastrointestinal absorption surface areas and motility affect (A) in the older adult population. Decreased hepatic blood flow, decreased hepatic mass, and decreased activity of hepatic enzymes affect (B) in older adults. Decreased renal blood flow, decreased glomerular filtration rate, decreased tubular secretion, and decreased number of nephrons affects (C) in an older adult.11) A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the LPN/LVN to obtain the trough level?

• Sixty minutes after the antibiotic dose is administered.
• Immediately before the next antibiotic dose is given.