NURS 180 PHARMACOLOGY QUIZ
ATI NURS 180 PHARMACOLOGY QUIZ
Total Questions : 24
Showing 10 questions Sign up for moreA charge nurse is teaching a group of nurses about the antagonist action of reversal medications. For each medication listed below, click to specify the expected reversal agent.
Explanation
Digoxin: The correct reversal agent for digoxin toxicity is Digibind (also known as digoxin immune Fab). This agent binds directly to digoxin, forming an inactive complex that the kidneys excrete, effectively reducing digoxin’s toxic effects.
Warfarin: Vitamin K acts as an antidote to warfarin by promoting clotting factor synthesis in the liver, counteracting warfarin’s anticoagulant effects. This reversal is particularly important in cases of bleeding or excessively high INR.
Beta blockers: Glucagon is used as a reversal agent in beta blocker overdose, as it increases heart rate and myocardial contractility by activating a pathway independent of beta-adrenergic receptors, which helps to mitigate severe bradycardia and hypotension.
Heparin: Protamine sulfate serves as the antidote for heparin, neutralizing its anticoagulant effect. Protamine binds with heparin to form a stable complex, reducing the risk of bleeding in cases of heparin overdose.
The nurse is caring for a client who suffers from frequent blood clots and is currently taking argatroban. Which of the following conditions in the client's medical history would require them to take argatroban?
Explanation
A) Heparin induced thrombocytopenia (HIT): Argatroban is an indirect thrombin inhibitor specifically used for anticoagulation in patients with HIT. This condition involves a significant drop in platelet counts due to heparin therapy, and argatroban is an appropriate alternative for preventing thrombosis in these patients.
B) Ventricular Dysfunction: While managing anticoagulation may be important in patients with ventricular dysfunction, this condition does not specifically necessitate the use of argatroban. Other anticoagulants may be used based on the clinical situation.
C) Myocardial infarction: Although anticoagulation may be warranted in the setting of a myocardial infarction, argatroban is not specifically indicated for this condition. Other antithrombotic therapies, such as aspirin or heparin, are more commonly used.
D) Hepatotoxicity: Argatroban is metabolized in the liver, so caution is warranted in patients with liver dysfunction. Hepatotoxicity itself would not be a reason to use argatroban; rather, it may require close monitoring or adjustment of dosage.
A client presents to the emergency healthcare setting and diagnosed with a life-threatening ventricular dysrhythmia. Which of the following medications would the nurse begin to prepare?
Explanation
A) Atenolol: This is a beta-blocker that can be used for various cardiac conditions, including hypertension and certain arrhythmias, but it is not typically the first-line treatment for acute life-threatening ventricular dysrhythmias in the emergency setting.
B) Lisinopril: This medication is an ACE inhibitor primarily used to manage hypertension and heart failure. It does not address acute ventricular dysrhythmias and would not be appropriate for immediate use in this scenario.
C) Adenosine: While adenosine is effective for certain types of supraventricular tachycardia, it is not indicated for life-threatening ventricular dysrhythmias. It has a very short duration of action and is not the drug of choice in this context.
D) Procainamide: This antiarrhythmic medication is specifically used to treat life-threatening ventricular dysrhythmias. It works by stabilizing the cardiac membrane and is indicated in emergency situations to manage these types of arrhythmias. Therefore, preparing procainamide is the most appropriate action for the nurse in this scenario.
The nurse is admitting a client of the Muslim faith during the holy month of Ramadan. The client tells the nurse that he must fast during this time. Which response by the nurse is the most appropriate?
Explanation
A) "What can we do to accommodate your needs during your stay here?" This response is the most appropriate as it demonstrates cultural sensitivity and respect for the client’s religious practices. It opens the door for a collaborative discussion about how the healthcare team can support the client’s fasting while ensuring that his health needs are met during hospitalization.
B) "I will let your healthcare provider know that you need to be discharged." While it is important to communicate the client’s needs to the healthcare provider, suggesting discharge may not be a feasible solution. It does not address the complexities of fasting during hospitalization and could imply that the client’s faith is a burden rather than a respected aspect of their care.
C) "Fasting may be harmful to your body during your illness." While it is crucial to ensure the client’s health is not compromised, this response could come off as dismissive of the client’s beliefs. Instead of expressing concern, it could be more beneficial to explore how fasting can be managed within the context of their medical care.
D) "You must eat a high protein diet during times of illness." This response does not take into account the client’s religious beliefs and fails to respect the significance of fasting in the Muslim faith. While dietary considerations are important, this approach disregards the client’s right to practice their faith and may come across as prescriptive rather than collaborative.
A client with hypertension and benign prostate hyperplasia is prescribed doxazosin (Cardura). Which of the following statements below would the nurse emphasize regarding doxazosin (Cardura)?
Explanation
A) "Increase your potassium intake by eating more bananas and apricots.": Doxazosin is not a potassium-sparing medication, and there is no specific indication for increased potassium intake with this drug. This advice may be misleading, especially since excessive potassium can pose risks, particularly in certain populations.
B) "Weigh yourself daily, and report any weight loss to your prescriber.": Daily weighing can be important for monitoring fluid retention in some conditions, but weight loss is not a common side effect of doxazosin. Instead, clients should be more concerned about weight gain due to fluid retention or potential side effects from the medication.
C) "The impaired taste associated with this medication usually goes away in 2 to 3 weeks.": Impaired taste is not a well-documented side effect of doxazosin. While some medications may cause changes in taste, this statement is not relevant for doxazosin and does not address the most critical aspects of its administration.
D) "Be sure to lie down after taking the first dose, because first-dose hypotension may make you dizzy.": This statement is accurate and important. Doxazosin can cause first-dose hypotension, leading to dizziness or fainting. Advising the client to lie down after the first dose helps mitigate the risk of hypotensive effects, making this the most appropriate emphasis for the nurse.
The nurse is educating a client on the possible side effects associated with quinapril. Which of the following side effects are associated with this medication classification?
(Select All that Apply)
Explanation
A) Angioedema: Quinapril, an ACE inhibitor, can cause angioedema, which is a serious allergic reaction characterized by swelling of the deeper layers of the skin. This side effect is critical to monitor, as it can lead to airway obstruction.
B) Dry non-productive cough: A persistent dry cough is a well-known side effect of ACE inhibitors like quinapril. This occurs due to the accumulation of bradykinin and can be bothersome enough to require discontinuation of the medication.
C) Hyperkalemia: Quinapril can lead to increased potassium levels in the blood, a condition known as hyperkalemia. This is due to the drug's mechanism of action, which reduces aldosterone secretion, leading to decreased potassium excretion.
D) First dose phenomenon: This refers to a significant drop in blood pressure following the first dose of an ACE inhibitor, which can lead to dizziness or fainting. Patients are often advised to take the first dose at bedtime to minimize this risk.
E) Hypotension: Quinapril can cause hypotension, particularly after the initial dosing or in patients who are dehydrated or on diuretics. It’s important for patients to be aware of this potential side effect.
F) Hypertension: Quinapril is used to treat hypertension, so it is not a side effect associated with this medication. Instead, the goal of treatment is to lower blood pressure, making this option incorrect.
A client who has just experienced a pulmonary embolism is administered alteplase (Activase). Which of the following side effects associated with this medication would the nurse assess for?
Explanation
A) Pancytopenia: While some medications can cause pancytopenia, it is not a common or direct side effect of alteplase. This condition involves a reduction in red blood cells, white blood cells, and platelets, and is not typically associated with thrombolytics.
B) Hypertension: Alteplase is not known to cause hypertension. In fact, the goal of administering alteplase in the context of a pulmonary embolism is to dissolve the clot and restore normal blood flow, which may help stabilize blood pressure.
C) Hypokalemia: This condition, characterized by low potassium levels, is not a common side effect of alteplase. There are other medications that may cause electrolyte imbalances, but alteplase itself is not typically linked to hypokalemia.
D) Internal bleeding: This is a significant risk associated with alteplase, as it is a thrombolytic agent that dissolves clots. The nurse should closely monitor for signs of internal bleeding, such as changes in vital signs, unexplained bruising, or blood in urine or stool. This is the most critical side effect to assess for in a client receiving alteplase.
The nurse is caring for a client with a history of hypertension who has experienced uncontrollable non-productive cough related to an ACE inhibitor. Which alternative medication would the nurse anticipate administering?
Explanation
A) Losartan (Cozaar): This medication is an angiotensin II receptor blocker (ARB) and is often used as an alternative for patients who experience a cough due to ACE inhibitors. Unlike ACE inhibitors, ARBs do not typically cause a cough because they do not affect bradykinin levels, making losartan an appropriate choice for managing hypertension without the adverse effect of a persistent cough.
B) Hydralazine HCL (Apresoline): While hydralazine is an antihypertensive, it works through a different mechanism (direct vasodilation) and is not a first-line alternative for patients with a history of ACE inhibitor-induced cough. It's generally used in specific situations, such as severe hypertension or heart failure.
C) Furosemide (Lasix): This is a loop diuretic primarily used for conditions like heart failure or edema, rather than for the management of hypertension alone. It does not address the underlying hypertension in the same manner as ACE inhibitors or ARBs.
D) Metoprolol (Lopressor): This is a beta-blocker that can be used for hypertension, but it does not directly address the issue of cough related to ACE inhibitors. Switching to a beta-blocker may not be the best option if the client is specifically seeking to avoid the cough associated with ACE inhibitors.
The nurse is caring for a client who is taking atorvastatin to assist in lowering his LDL cholesterol. Which lab value must be routinely done with this medication to prevent complications?
Explanation
A) Platelet counts: Monitoring platelet counts is not necessary with atorvastatin therapy. While certain medications may affect platelet levels, atorvastatin primarily targets lipid levels and does not have a significant impact on platelet function.
B) Lung function test: Lung function tests are not relevant for atorvastatin use. These tests are typically utilized for assessing respiratory conditions and are not part of the routine monitoring for cholesterol-lowering medications.
C) Liver function test: Atorvastatin can affect liver function, so it is essential to monitor liver enzymes (such as AST and ALT) regularly. Routine liver function tests help identify any potential hepatotoxicity early, allowing for timely intervention if liver function declines.
D) Bun and creatinine levels: While monitoring renal function can be important in some contexts, it is not a routine requirement specifically for atorvastatin. However, it may be necessary in certain patient populations or if there are concerns about kidney function, but liver function tests are the primary focus with this medication.
A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation digoxin toxicity? (Select all that apply.)
Explanation
A) Constipation: While constipation can occur with digoxin use, it is not a classic sign of digoxin toxicity. Therefore, it is less critical for the client to monitor this symptom specifically in relation to toxicity.
B) Dark red urine: Dark red urine is not typically associated with digoxin toxicity. This symptom could indicate other conditions, such as blood in the urine or issues with the kidneys, but it is not a direct manifestation of digoxin toxicity.
C) Bradycardia: Digoxin toxicity can lead to bradycardia, characterized by a slower than normal heart rate. The client should be instructed to monitor their pulse and report any significant changes, especially if the heart rate drops below 60 beats per minute.
D) Nausea: Nausea is a common symptom of digoxin toxicity. Clients should be aware of this and report any persistent or severe nausea, as it may indicate that the digoxin levels in their system are too high.
E) Vomiting: Vomiting is another classic sign of digoxin toxicity. Clients should be instructed to report any episodes of vomiting, as this can further complicate their condition and may require adjustment of their medication.
F) Anorexia: Anorexia, or loss of appetite, can also occur with digoxin toxicity. Clients should be advised to monitor their appetite and report any significant changes, as this can be an early indicator of toxicity.
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