Pharmacology

Question 1
To fully understand how a drug works, basic pharmacology information should be understood. The action of the drug on the human body is called:

Pharmacokinetics Half-life Pharmacodynamics Potency

Question 1 Explanation:Pharmacodynamics is the action of the drug on the human body. Pharmacokinetics is defined as what the body does with drug (Absorption, distribution, metabolism and excretion). Drug half-life is period of time it takes for a substance undergoing decay to decrease by half. Potency is a measure of how much a drug is required in order to produce a particular effect. Therefore, only a small dosage of a high potency drug is required to induce a large response.

Question 2
Which of the following condition should the nurse withhold Mannitol administration in a client?

Increase intracranial pressure Dehydration Toxic overdose Acute oliguric phase of renal failure
Question 2 Explanation:Contraindications of Mannitol include dehydration and hypersensitivity. Increase ICP, toxic overdose and acute oliguric renal failure are all indications of Mannitol administration.

Question 3
Which of the following beverages is discouraged to be taken with Methotrexate because it decreases the drug efficacy:

Alcohol Milk Caffeine

Water
Question 3 Explanation:Caffeine may decrease the efficacy of the drug. Alcohol use during Methotrexate therapy increases the hepatotoxic potential but it does not decrease the efficacy of the drug. Milk and water has nothing to do with the absorption of the drug.

Question 4
A client is diagnosed with leukemia. Methotrexate has been prescribed by the doctor. If a very highdose of drug is administered to the client which of the following medications should the nurse prepare to prevent fatal toxicity?

Calcium Gluconate Leucovorin Calcium Edetate Calcium Disodium Phenytoin

Question 4 Explanation:Leucovorin Calcium. If Methotrexate is administered in high doses, the patient must receive Leucovorin Calcium rescue within 24-48 hours to prevent fatal toxicity. To prevent hematologic toxicity (platelet levels are decreased) salicylates, NSAIDs, phenytoin, tetracycline and chlorampenicol should be avoided. Edetate Calcium Disodium is used for the treatment of lead poisoning. Calcium gluconate is the antidote for magnesium toxicity.

Question 5
The client on Methotrexate therapy is asking about the drug contraindications. The following are contraindications of the drug apart from:

Pregnancy Allergic reaction to the drug Ectopic pregnancy Hypersensitivity

Question 5 Explanation:Ectopic pregnancy is an indication of Methotrxate therapy. Death of rapidly replicating cells (e.g. cancer cells, choriocarcinoma, leukemia, carcinoma in different body parts and ectopic pregnancy) specifically the malignant ones is made possible through Methotrexate administration. Contraindications of Methotrexate: Known allergic hypersensitivity to the drug Pregnancy

Question 6

Take thou symbol, clients name, address and age are contained in what part of prescription?

Superscription Subscription Inscription Signature

Question 6 Explanation:Superscription clients name, address and age. The symbol of take thou is also located here. Subscription directions about the number of tablets or amount to be dispersed that is given to the pharmacist. Inscription contains the drug name, strength and dose.

Question 7
The physician is discussing about the medication regimen to the patient. The doctor said that only a small dosage of a high potency drug is required to induce a large response in the body. Potency is defined as:

The process of absorbing, distributing, metabolizing and excreting the drug. Refers to the maximum response achievable from a drug. Measure of the concentration of a drug at which it is effective. d. A reduction in response to an agonist while it is continuously present at the receptor, or progressive decrease in response upon repeated exposure to an agonist.
Question 7 Explanation:a. The process of absorbing, distributing, metabolizing and excreting the drug. pharmacokinetics b. Refers to the maximum response achievable from a drug. efficacy c. Measure of the concentration of a drug at which it is effective. potency d. A reduction in response to an agonist while it is continuously present at the receptor, or progressive decrease in response upon repeated exposure to an agonist. desensitization

Question 8
A nurse is carrying out the doctors order. Which of the following drugs should the nurse question if the doctor prescribed it to a client on Methotrexate therapy, who has been observed with bleeding gums, blood in stools, urine and vomitus?

Naproxen Allopurinol Leucovorin

Vincristine
Question 8 Explanation:To prevent hematologic toxicity (platelet levels are decreased) salicylates, NSAIDs, phenytoin, tetracycline and chlorampenicol should be avoided. Examples of NSAIDs are aspirin, indomethacin (Indocin), ibuprofen (Motrin), naproxen (Naprosyn), piroxicam (Feldene), and nabumetone (Relafen). Allopurinol is used to decrease uric acid in Methotrexate therapy. Leocovorin is given for Methotrexate overdose. Vincristine is an anticancer drug used alone or with other antineoplastics (e.g. Methotrexate) in treating cancer/leukemia.

Question 9
A client is prescribed with mannitol. What is the classification of mannitol?

Potassium sparing diuretic Loop diuretic Osmotic diuretic Potassium wasting diuretic
Question 9 Explanation:Mannitol is an osmotic diuretic that is indicated in the following conditions: 1. Acute oliguric renal failure 2. Toxic overdose 3. Edema 4. Increased intracranial pressure (ICP) 5. Intraocular pressure (IOP)

Question 10
The antidepressant Amitriptyline (Elavil) has the half life of 10-50 hours. What is a drug half-life?

Drug half-life is period of time it takes for a substance undergoing decay to decrease by half Drug half-life is period of time it takes for a substance undergoing decay to increase by half Drug half-life is the period of time required for the concentration or whole amount of drug in the body to be fully metabolized Letters A and C
Question 10 Explanation:Drug half-life is the period of time required for the concentration or amount of drug in the body to be reduced or decrease by one-half.

Question 11
The doctors order is Acyclovir (Zovirax) ung. 5 times a day. UNG stands for:

As directed Ointment Suspension Label

Question 11 Explanation:Ung. Stands for ointment. (Source: Clinical Ocular Pharmacology by Jimmy D. Bartlett, Siret D. Jaanus) a. As directed ut dict. b. Ointment ung. c. Suspension susp. d. Label sig.

Question 12
The following adverse effects are observed in a client taking Mannitol apart from:

Nausea and vomiting Hypokalemia Blurred vision Bradycardia

Question 12 Explanation:Adverse reactions 1. Dehydration 2. Intracranial bleeding 3. Headache 4. Blurred vision 5. Nausea and vomiting 6. Volume expansion 7. Chest pain 8. Pulmonary edema 9. Thirst 10. Tachycardia 11. Hypokalemia

Question 13
If edema and joint pains is observed in a client taking Methotrexate, which of the following medications would the nurse expect the doctor to prescribe?

Succimer NSAIDs Salicylates Allopurinol

Question 13 Explanation:Allopurinol (Zyloprim) is used to treat gout or kidney stones, and to decrease levels of uric acid in certain cancer patients. Methotrexate therapy increases the levels of uric acid in the blood resulting to gout. Symptoms of gout include edema and joint pain. To prevent hematologic toxicity (platelet levels are decreased) salicylates, NSAIDs, phenytoin, tetracycline and chlorampenicol should be avoided. Succimer is a chelating agent for lead poisoning.

Question 14
A client on Mannitol therapy is also taking Digoxin, a cardiac glycoside. Which of the following electrolyte level should the nurse monitor to assess for the risk of digoxin toxicity?

Potassium Sodium Creatinine Platelet

Question 14 Explanation:Hypokalemia increases the risk of digoxin toxicity, thus, the nurse should monitor potassium levels of a client taking Digoxin with Mannitol (adverse effects of Mannitol include hypokalemia).

Question 15
The client is asking regarding Methotrexate therapy. If a dose is missed what should the client do?

It should be omitted. It should be taken within 4 hours after the missed dose. The next dose should be doubled. It should be taken within 24 hours after the missed dose.
Question 15 Explanation:If a dose is missed, it should be omitted. (Source: Davis Drug Handbook).

Question 16
The staff nurse is carrying out doctors order. A medication is ordered: Ampicillin 500 mg PO q6h. This is under what type of medication order?

PRN order Stat Order Single order Standing Order

Question 16 Explanation:A standing order is carried out until the physician cancels it by another order or until a prescribed number of days elapse. PRN orders are administered when the client needs/requires it. (Example is Acetaminophen 500 mg q6h PRN for fever) Single orders are one-time orders where the drug is only given

once at a specified time. (Example: Valium 10 mg PO at 10:00 am) A stat order signifies that a single dose is to be administered immediately and only one. (Example: Give Apresoline 10 mg IM stat)

Question 17
Extreme precaution should be observed by the nurse throughout Methotrexate therapy. Specific conditions of client impose extreme precaution in administering the drug. Extra precautions in Methotrexate therapy is least likely observed in which condition:

Trophoblastic neoplasms Preexisting liver damage Impaired renal function Infection

Question 17 Explanation:Trophoblastic neoplasm (choriocarcinoma, Lymphosarcoma) is an indication of giving Methotrexate. Extra precautions in administering Methotrexate should be observed in the following conditions: Preexisting liver damage or impaired hepatic function Methotrexate may be hepatotoxic. Even without previous signs of GI or hematologic toxicity such as liver atrophy, necrosis and cirrhosis. Special caution should be observed in clients with preexisting liver damage or impaired hepatic function. Presence of infection, peptic ulcer, ulcerative colitis, geriatric patients or patients with chronic debilitating illnesses. This drug has an immunosuppressive action. Thus, extreme caution should be observed in patients where immune responses may be vital for healing from a certain disease. Impaired renal function

Question 18
Directions about the number of tablets or amount to be dispersed are located in which part of prescription?

Superscription Subscription Inscription Signature

Question 18 Explanation:Subscription directions about the number of tablets or amount to be dispersed that is given to the pharmacist. Superscription clients name, address and age. The symbol of take thou is also located here. Inscription contains the drug name, strength and dose.

Question 19
The nurse is providing health teaching on a client who is on Methotrexate therapy. The following actions should be observed by the client throughout the course of therapy except:

Use a soft-bristled toothbrush. Use sunscreen and protective clothing. Use electric razor in removing mustache. Use OTC drugs and salicylates in treating fever.
Question 19 Explanation:Salicylates should be avoided to prevent bleeding tendencies as Methotrexate decreases platelet count. OTC drugs should not be taken by the client unless approved by the physician. Soft-bristled brush and electric razor (non-electrical razor poses more risk of bleeding) should be used to prevent bleeding. Sunscreen and protective clothing is used to prevent photosensitivity reactions.

Question 20
The novice nurse on a unit is reviewing the medication orders of the physician. One client has an order of Decadron 10 mg qd x 5 days. This medication order is an example of:

PRN order Stat Order Single order Standing Order

Question 20 Explanation:A standing order is carried out until the physician cancels it by another order or until a prescribed number of days elapse. PRN orders are administered when the client needs/requires it. (Example is Acetaminophen 500 mg q6h PRN for fever) Single orders are one-time orders where the drug is only given once at a specified time. (Example: Valium 10 mg PO at 10:00 am) A stat order signifies that a single dose is to be administered immediately and only one. (Example: Give Apresoline 10 mg IM stat).

Question 21
A nurse is providing health teaching to the client who is on Methotrexate therapy. The drug regimen must be discontinued the client would manifest which of the following symptoms?

Abdominal pain Diarrhea

Ulcerative stomatitis All of the above

Question 21 Explanation:The client taking Methotrexate should be monitored for abdominal pain, diarrhea or ulcerative stomatitis. Therapy may be discontinued with the presence of these toxic effects otherwise, hemorrhagic enteritis and death from intestinal perforation may occur.

Question 22
A prescription was given by the physician. The part where the drug name, strength and dose is written is called:

Superscription Subscription Inscription Personal data

Question 22 Explanation:Inscription contains the drug name, strength and dose. Superscription clients name, address and age. The symbol of take thou is also located here. Subscription directions about the number of tablets or amount to be dispersed that is given to the pharmacist.

Question 23
Acyclovir (Zovirax) is classified as:

Anti-infective Antiviral Antihypertensive NonSteroidal Anti-Inflammatory Drug

Question 23 Explanation:Zovirax is an antiviral medication used to treat recurrent genital herpes infections, shingles and chickenpox.

Question 24
To assess for the renal function of the patient taking Mannitol, which of the following laboratory values should the nurse obtain?

ALT, AST

WBC and Platelet Count Sodium and potassium BUN and creatinine
Question 24 Explanation:a. ALT, AST for liver function b. WBC and Platelet Count blood studies c. Sodium and potassium serum electrolyte d. BUN and creatinine renal function

Question 25
Every drug has a side effect or adverse reaction. In Methotrexate therapy, which adverse reaction will be observed in the client?

Anorexia Leukocytosis Increase platelet count Constipation

Question 25 Explanation:Adverse Reactions of Methotrexate 1. Dizziness 2. Drowsiness 3. Headaches 4. Malaise 5. Anorexia 6. Nausea and vomiting 7. Hepatoxicity 8. Alopecia 9. Ulcerative stomatitis 10. Leukopenia 11. Chills and fever 12. Photosensivity 13. Thrombocytopenia 14. Hyperurecemia