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School of Nursing
Introduction to Pharmacology
Phase III – Medications
Final Examination
Instructions:

1. This is an open book examination. 2. It is suggested that you review one module at a time and answer questions applicable to the particular module. There are four questions per module and modules can be completed in any order as one module does not build on the other. 3. There are two bonus questions at the end of the examination. Even if you answered all 50 questions correct, your maximum score would be 100%. However if you only missed two questions but answer the two bonus questions correctly, your final grade would be 100%. 4. Select the answer that is correct from choices provided. 5. All questions in each section were taken directly from the Phase III Study Guide. (This does not apply to the two bonus questions however they were taken from the study material). 6. The following is a listing of modules:
MODULE CLASSIFICATION OF MEDICATION
MATERNITY AND NEWBORN MEDICATIONS
1. Ergonovine Maleate (Ergotrate) is used primarily to: a. Increase the frequency and force of contraction for purposes of delivery b. Increase vasodilation for purposes of oxygenating the fetus c. Increase the frequency and force of contraction for purposes of delivery d. Relax the smooth muscles of the uterus. 2. The mother of a newborn observes the nurse administering an injection into her newborn’s vastus lateralis muscle. Noticing her interest the nurse explains that the Hepatitis B Vaccine is administered at what interval? a. At birth and 1, 4, 6, and 18 months of age b. At birth and 2, 4, 18, and 24 months of age c. At birth and 1 and 4 months of age d. At birth and 3, 6, 9, and 12 months of age 3. A maternity patient has been admitted to the hospital with pregnancy induced hypertension (PIH) and is being treated with Magnesium Sulfate for purposes of preventing seizures. During her frequent assessment of the patient she notes during one assessment that the patient’s respirations are 11 per minute and urine output is 24 ml per hour. With this assessment data the nurse would: a. Continue to monitor the patient b. Increase fluid intake c. Call the physician and report her findings d. Retake the vital signs in thirty minutes; if remain the same call the 4. Which of the following statements is correct regarding Meperidine Hydrochloride (Demerol): a. The medication can be given in the early stage of labor b. The medication can be given within one hour of expected delivery c. The primary concern with this medication is that it may increase d. Since it may cause nausea, the medication can be administered with MODULE II
INTEGUMENTARY MEDICATIONS
5. An LVN has been assigned to irrigate a wound that is infected with Pseudomonas aeruginosa. Which antiseptic would the nurse expect the physician to order for her to clean the wound? a. Chlorhexidine Gluconate (Hibiclens) b. Acetic Acid c. Hydrogen Peroxide d. Hexachlorophene (pHisoHex, Septisol) 6. Which of the following is not an emollient agent? a. Glycerin b. Petrolatum c. Lanolin d. Potassium permanganate 7. Which classification of medication promotes natural healing without the usual formation of dry crust over the wound? a. Emollients b. Lotions c. Rubs and liniments d. Protectives. 8. Which anti-infective agent has an effervescent action that releases gas and breaks up necrotic tissue? a. Sodium Hypochlorite (Dakin solution) b. Hydrogen Peroxide c. Chlorhexidine Gluconate (Hibiclens) d. Acetic Acide MODULE III
ANTINEOPLASTIC MEDICATIONS
9. A 38 year old female patient is being treated with Cisplatin (Platinol) in combination with other chemotherapy agents. In the treatment of the patient the nurse knows that there are substantial side effects associated with administering Cisplatin. Which of the following is not an expected side effect? a. Anorexia, nausea, vomiting b. Ototoxicity c. Thick hair growth on the face d. Gonadal suppression Suggesting that the patient consider purchasing a wig prior to the initiation of chemotherapy would be supportive of? a. Physiological Integrity b. Safe, effective, care environment c. Psychosocial Integrity d. Health Promotion and Maintenance Which of the following is an Antitumor Antibiotic Medication? a. Busulfan (Myleran) b. Chlorambucil (Leukeran) c. Cisplatin (Platinol) d. Bleomycin sulfate (Blenoxane) As part of chemotherapy being provided to the patient, the physician has ordered Dacarbazine (DTIC). The nurse advises the patient of the need for a daily intake of 2 to 3 liters of fluid. She also knows that the patient may experience nausea. Therefore, to counter the effects of nausea, the nurse will administer antiemetics, as ordered: a. With meals b. Shortly after meals c. 30 to 60 minutes before Dacarbazine is administered to the patient d. Two to three hours after meals MODULE IV
ENDOCRINE MEDICATIONS
Which hormone is used to replace hormonal deficit in the treatment of hypothyroidism, myxedema, or cretinism? a. Parathyroid Hormone b. Thyroid Hormone c. Somatotropin d. Adrenocorticotropic Hormone A patient is being treated for diabetic insipidus secondary to a gunshot wound that damaged the posterior pituitary gland. The patient asks why Vasopressin (Pitressin) was ordered by the doctor. The nurse would be correct in her response if she stated: a. Only the physician knows for sure. b. The medication controls urinary output so you should urinate less. c. The medication causes an increase in urine output so you should d. The medication performs the same function as the posterior pituitary Sheila Thompson, a 43 year old waitress has bilateral radical mastectomy following diagnosis of breast cancer. The physician is considering prescribing Progestins. Which of the following is not a Progestin class of medication? a. Hydroxyprogesterone caproate (Duralutin) b. Desmopressin (Stimate) c. Medroxyprogesterone acetate (Depo-Provera) d. Mgestrol acetate (Megace) A 67 year old male that was recently diagnosed with Type 1 diabetes has been prescribed Humulin R (regular insulin). If the morning dose is administered at 7:30 a.m., when should the peak effect of the medication take place? a. The peak should be between 2 and 12 hours b. The peak should be between 16 and 18 hours c. The peak should be between 2 and 4 hours d. The peak should be between 6 and 12 hours GASTROINTESTINAL MEDICATIONS
The physician has ordered Amphogel and sucralfate (Carafate) to be administered to a patient with a peptic ulcer. To minimize the effect Amphogel has on the Carafate the nurse should administer Amphogel? a. One hour before meals b. One hour after meal c. One hour apart from Carafate d. At the same time with ample fluids The physician has ordered Cimetidine (Tagamet) for a patient with an ulcer. She knows that a patient with renal impairment being treated with Tagamet should? a. Receive the standard adult dose. b. The dose should be increased to compensate for renal impairment. c. The dose should be decreased due to the renal impairment. d. The dose should be 1 ½ times the normal adult dose. The Histamine H2 Inhibitor Ranitidine (Zantac) can be safely administered? a. Orally (PO) b. Intramuscular (IM) c. Intravascular (IV) d. All the above The patient has hepatitis. The physician orders Cholestyramine (Questran, Prevalite) for pruritis. Which side effect would a patient most likely not complain about: a. Diarrhea b. Bloating c. Flatulence d. Nausea MODULE VI
RESPIRATORY MEDICATIONS
Which of the following is not a proper instruction to a patient using an inhaler? a. Shake inhaler well before using b. Remove cap from inhaler c. Breathe deeply in and out through the nose d. Insert the mouthpiece into the mouth or in front of the open mouth Which of the following is a Second-Line Medication in the treatment of tuberculosis? a. Isoniazid (INH) b. Rifampin (Rifadin) c. Ehambutol HCl (Myambutol) d. Kanamycin sulfate (Kantrex) A patient is receiving Demerol in the second stage of labor. Her respirations have decreased to 10 per minute. Upon assessment the physician determines that the decrease in respiration is most likely due to the patient receiving the narcotic Demerol. The nurse anticipates that the physician will order which medication to counter the effects of the Demerol? a. Epinephrine (Adrenalin b. Naloxone hydrochloride (Narcan) c. Dexamethasone (Decadron) d. Oxtriphylline (Choledyl) Which of the following is not a side effect of Triamcinolone (Amcort, Aristocort, Azmacort)? a. Impaired immune response b. Puffy eyelids and edema in the lower extremities c. Moon face d. Hyperkalemia MODULE VII
CARDIOVASCULAR MEDICATIONS
What is the desired clotting time for a patient on Heparin Sodium (Liquaemin Sodium)? a. 1 to 3 minutes b. 8 to 15 minutes c. 15 to 20 minutes d. 20 to 30 minutes Following a cardiac arrest the physician prescribed the anticoagulant Warfarin sodium (Coumadin) for the patient. The nurse knows that the antidote for the medication is? a. Protamine Sulfate b. Benadryl c. Universal antidote d. Vitamin K The therapeutic dose range of Digoxin (Lanoxicaps, Lanoxin) is? a. 0.5 to 2.0 ng/mL b. 5.0 to 10.0 ng/ml c. 0.1 to 0.4 ng/ml d. 1.5 to 3.0 ng/ml All of the following statements are true regarding Calcium Channel Blockers except one. Calcium Channel Blockers: a. Increase cardiac contractility (negative inotropic effect by relaxing smooth muscle) and the workload of the heart, thus decreasing the need for oxygen b. Promote vasodilation of the coronary and peripheral vessels c. Are used for angina, dysrhythmias,and hypertension d. Are used with caution in clients with CHF, bradycardia, or AV block MODULE VIII
RENAL MEDICATIONS
Which one of the following medications is not in the Sulfonamide class of drugs? a. Norfloxacin (Noroxin) b. Sulfisoxazole (Gantrisin) c. Sulfamethoxazole (Gantanol, Urobak) d. Trisulfapyrimidines (Triple Sulfa No. 2) Which one of the following medications is used to treat nonobstructive urinary retention and neurogenic bladder? a. Azathioprine (Imuran) b. Mycophenolate mofetil (CellCept) c. Bethanechol chloride (Duvoid, Urecholine) d. Prednisone (Deltasone) A patient has been prescribed Sulfisoxazole (Gantrisin) for a urinary tract infection. Which of the following instructions to the patient would be inappropriate? a. Maintain a daily urine output of 1200 mL by consuming 8 to 10 glasses of water each day to minimize the risk of renal damage from the medication b. The medication can cause hemolytic anemia and agranulocytosis, c. Instruct client to take medication after eating d. Instruct the client to avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin Regarding the urinary analgesic henazopyridine HCl (Pyridium) all of the following statements are true except? a. Pyridium is used for urinary tract pain. b. Pyridium is known to turn the patient’s urine orange or red. c. Pyridium can be used to kill microorganisms d. Pyridium may cause the patient to feel nauseated MODULE IX
OPTHALMIC AND OTIC MEDICATIONS
The nurse is to administer an otic medication to a two year old toddler. The nurse knows that when instilling medication to a small child the auricle should be? a. Pulled up and back to straighten external canal b. Pulled straight down to instill ear drops c. Pulled down and back for infants and children younger than 3 years of When applying eye ointment the nurse should do all of the following except? a. Hold the ointment tube near, but not touching the eye or eyelashes b. Squeeze a thin ribbon of ointment along the lining of the sac from the c. Instruct the client to open and close the eyes gently as the medication d. Instruct the client that vision may be blurred by the ointment The physician determines that the patient has excess cerumen which is causing the patient discomfort. He requests the nurse to irrigate the ear. When performing the task, the nurse will do all of the following except: a. Ensure that there is direct visualization of the tympanic membrane b. Warm irrigating solution to 86° F c. Perform the irrigation gently to avoid damage to the eardrum d. Ensure that the irrigation solution is directed away from the eardrum The patient has been prescribed a Ccholinesterase Medication Physostigmine salicylate (Isopto Eserine). Which of the following is not a toxic effect? a. Frequent urination b. Bradycardia c. Cardiac dysrhythmias d. Seizures NEUROLOGICAL MEDICATIONS
All of the following are signs of a Cholinergic Crisis except? a. Hypotension b. Increased bronchial secretions c. Abdominal cramps d. Miosis a. Restore the balance of the neurotransmitters acetylcholine and dopamine in the CNS, decreasing the signs and symptoms of Parkinson’s disease b. For drug-induced parkinsonism, in which neuroleptic agents block dopamine receptors in the CNS, leading to functional loss of dopamine activity c. For Parkinson’s disease, in which dopamine-containing neurons in the basal ganglia are destroyed or deficient, which causes loss of fine motor control Regarding Morphine Sulfate, which of the following statement is a. The medication may cause hypertension. b. The medication can be used with a patient with increased c. The medication is contraindicated with patients in severe respiratory d. May cause an increase in pupillary size. Which of the following medications specifically should not be administered to a patient taking MAO Inhibitors? a. Dantrolene (Dantrium) b. Cyclobenzaprine HCl (Flexeril) c. Methocarbamol (Robaxin) d. Chlorzoxazone (Paraflex, Parafon Forte) MODULE XI
MUSCULOSKELETAL MEDICATIONS
Which of the following medications is not used in the treatment of a. Auranofin (Ridaura) b. Allopurinol (Zyloprim) c. Probenecid (Benemid) d. Sulfinpyrazone (Anturane) What classification of medication is Auranofin (Ridaura)? a. Gold Therapy Medication b. Anti-gout Medication c. Skeletal Muscle Relaxant d. Anti-Arthritic Medication All of the following statements are true regarding musculoskeletal a. Medications act directly on the neuromuscular junction or indirectly b. Centrally acting muscle relaxants depress neuron activity in the c. Peripherally acting muscle relaxants act directly on the skeletal d. Can be safely taken by patients with severe liver, renal, or severe If a patient is on Allopurinol (Zyloprim) or Colchicine they should be instructed to do all of the following except? a. Limit fluids to 1,000 mL a day while on the medication. b. The patient should avoid alcohol intake. c. Avoid foods high in purine such as wine, alcohol, organ meats, MODULE XII
PSYCHIATRIC MEDICATIONS
Which of the following is a side effect of Fluoxetine hydrochloride a. Central Nervous System suppression b. Weight gain c. Moist mucus membranes d. Insomnia A patient taking MAO Inhibitors for depression should avoid foods containing Tyramine as it may precipitate a Tyamine crisis manifested by hypertension. Which of the following foods are known to have a high Tyramine content? a. Aged cheese b. Meat tenderizers c. Red wine, beer, or sherry d. All the above A patient taking Lithium Carbonate can experience severe toxicity if a. 1.0 mEq/L b. 1.5 mEq/L c. 2.0 mEq/L d. 2.5 mEq/L A patient attempted suicide by overdosing on Zolpidem tartrate (Ambien). Which of the following signs and symptoms would the nurse expect to see? a. Bradycardia b. Hypertension c. Constricted pupils d. Depressed respirations BONUS QUESTIONS
You do not have to answer the questions below. These are bonus questions that will not harm your grade, but may improve it. Epoetin alfa (Epogen, Procrit) is used in the treatment of chronic renal failure and reverses anemia by stimulating red cell production. Spironolactone (Aldactone) is a potassium sparing diuretic. While a patient is on the medication, the nurse should monitor for signs and symptoms of hyperkalenia? Name: _______________________________________________________________________ Mailing Address: ______________________________________________________________ Telephone Number: ( ) ______________________________________________________ E-mail address: ________________________________________________________________ INTRODUCTION TO PHARMACOLOGY
ANSWER SHEET : Phase III- Medications
You may submit answer sheet by the following: Mail: West Haven University, 5825 Lincoln Avenue D123, Buena Park, CA 90620 Fax: (714) 828-3738 E-mail: drcharlesfrye@westhavenuniv.com (Scan and attach to an e-mail or type your answer in the e-mail, for example 1.a 2.b .)

Source: http://www.westhavenuniv.edu/halldownloads/1099/Phase_III_Final_Exam.pdf

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