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Pharm Flashcards

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1
Q

Beta-Blockers primarily block which of the following?

A

Beta I and/or Beta II receptors

Beta-Blockers end in -LOL and block the effects of epinephrine/norepinephrine at the adrenergic receptor sites, decreasing heart rate and blood pressure.

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2
Q

Which side effect is a common reason patients discontinue ACE Inhibitors?

A

Persistent, dry cough

The dry, irritating cough is a very common side effect of ACE Inhibitors (ending in -PRIL), caused by the accumulation of bradykinin.

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3
Q

A patient receiving a Calcium Channel Blocker reports ankle swelling due to:

A

Systemic vasodilation

CCBs, especially the dihydropyridine class, cause systemic vasodilation to decrease BP, which often leads to peripheral edema.

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4
Q

Angiotensin II Receptor Blockers (ARBs) work by blocking the effects of Angiotensin II at __________.

A

receptor sites

ARBs (ending in -SARTAN) prevent vasoconstriction and aldosterone-producing effects.

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5
Q

The most important electrolyte to monitor in a patient taking both an ACE Inhibitor and a Potassium-Sparing Diuretic is:

A

Potassium

ACE Inhibitors cause potassium retention, and combined with a Potassium-Sparing Diuretic, the patient is at high risk for hyperkalemia.

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6
Q

The therapeutic effect of Digoxin that should be emphasized is:

A

Increased force of myocardial contraction

Cardiac glycosides like Digoxin have a positive inotropic effect.

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7
Q

Which condition makes a patient most susceptible to developing digitalis toxicity?

A

Hypokalemia

Low potassium levels (K^+) increase susceptibility to digitalis toxicity, even if Digoxin levels are therapeutic.

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8
Q

A patient taking a statin should report which symptom immediately?

A

Unexplained muscle pain or weakness

Statins can cause rhabdomyolysis, which must be reported immediately.

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9
Q

The antidote for Dabigatran (Pradaxa) in case of life-threatening bleeding is:

A

Idarucizumab (Praxbind)

Idarucizumab is the specific antidote for Dabigatran, a direct inhibitor of free thrombin.

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10
Q

Apixaban and Rivaroxaban are direct inhibitors of __________.

A

Activated factor X (factor Xa)

They are direct, highly selective, orally active inhibitors.

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11
Q

Which instruction is most important for a patient prescribed a Dihydropyridine CCB?

A

Change positions slowly

CCBs cause vasodilation and decreased blood pressure, putting the patient at risk for orthostatic hypotension.

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12
Q

The primary goal of prescribing a Beta-Blocker for a patient with angina pectoris is:

A

Decreasing BP and heart rate to reduce oxygen demand

Beta-Blockers decrease the heart’s workload, which decreases myocardial oxygen demand.

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13
Q

Which statement about Rivaroxaban (Xarelto) is correct?

A

It is licensed for treatment of DVT and PE

Rivaroxaban is additionally licensed for treatment of deep-vein thrombosis and pulmonary embolism.

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14
Q

A serious, but rare, side effect of Acetaminophen (Tylenol) is:

A

Hepatotoxicity

Exceeding the maximum dose can lead to severe and sometimes irreversible liver damage.

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15
Q

A non-dihydropyridine CCB primarily works to decrease __________.

A

SA and AV conduction

Non-dihydropyridine CCBs have significant SA and AV node depressant effects.

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16
Q

Which instruction is essential for a patient who uses a Steroid Inhaler?

A

Rinse the mouth thoroughly after use

This is essential to prevent oral candidiasis (thrush).

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17
Q

Albuterol, a Beta 2 Adrenergic agonist, causes which effect?

A

Bronchodilation

Albuterol stimulates beta-2 receptors in the bronchi, causing relaxation of the smooth muscle.

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18
Q

The nurse should assess for which serious side effect when a patient is taking Theophylline?

A

Dysrhythmias

Theophylline has a narrow therapeutic range, and serious side effects include dysrhythmias and convulsions.

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19
Q

A common side effect of Diphenhydramine (Benadryl) is:

A

Drowsiness and anticholinergic effects

Diphenhydramine is known for causing significant sedation and anticholinergic effects.

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20
Q

The best ‘natural expectorant’ is __________.

A

Hydration (increased fluid intake)

Hydration is highlighted as the best natural expectorant for loosening bronchial secretions.

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21
Q

Which instruction is most important for a patient using a Nasal Decongestant Spray for several days?

A

Do not use for more than 3-5 days to prevent rebound congestion

Frequent use can cause rebound nasal congestion, often in as little as 3 days.

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22
Q

Ipratropium works by binding to cholinergic receptors to cause __________.

A

bronchodilation

Ipratropium is an anticholinergic that causes bronchodilation.

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23
Q

The mechanism of action for Montelukast (Singulair) is as a __________.

A

Leukotriene receptor antagonist

Montelukast blocks the action of leukotrienes, which cause inflammatory changes.

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24
Q

Common side effects to monitor for in a patient taking Dexamethasone include:

A
  • Hyperglycemia
  • Muscle wasting
  • Easy bruising/thinning skin

Glucocorticoids cause metabolic changes including hyperglycemia, muscle wasting, and thinning of the skin.

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25
A key side effect to monitor for with **Codeine** is:
CNS depression and constipation ## Footnote Codeine is an opioid-based antitussive with side effects including CNS depression.
26
Compared to first-generation antihistamines, second-generation antihistamines are preferred because they cause __________.
Less sedation/drowsiness ## Footnote Second-generation antihistamines are non-sedating.
27
Glucocorticoids are used in respiratory illnesses primarily for their __________.
Anti-inflammatory properties ## Footnote Glucocorticoids are defined as having anti-inflammatory properties.
28
When prescribing **Albuterol**, the nurse should instruct the patient to assess their:
Pulse and lung sounds ## Footnote Beta-2 agonists like Albuterol can cause nervousness and tachycardia.
29
Theophylline has a narrow therapeutic range of __________.
10-20 mcg/mL ## Footnote The notes refer to the narrow range by stating the therapeutic range.
30
Guaifenesin works by __________.
Loosening bronchial secretions ## Footnote Guaifenesin is an expectorant that thins bronchial secretions.
31
A patient prescribed **Furosemide** (Lasix) is at high risk for:
Hypokalemia and electrolyte imbalances ## Footnote Loop diuretics can lead to significant loss of potassium and other electrolytes.
32
Spironolactone is classified as a __________.
Potassium-sparing diuretic ## Footnote Spironolactone is noted as a potassium-sparing diuretic.
33
The nurse administering **Furosemide** should educate the patient about signs of hypokalemia, which include:
* Muscle cramps * Weakness ## Footnote Signs of hypokalemia include muscle weakness, cramps, and arrhythmias.
34
Hydrochlorothiazide (HCTZ) is classified as a __________.
Thiazide diuretic ## Footnote HCTZ is specifically labeled as a thiazide diuretic.
35
Bethanechol is primarily used for __________.
Urinary retention ## Footnote The notes state Bethanechol is used for urinary retention.
36
Which instruction is crucial for a patient taking **Sulfamethoxazole/Trimethoprim**?
Increase fluid intake ## Footnote The notes advise to increase fluid intake for Sulfa Drugs.
37
Oxybutynin chloride is used for __________.
Overactive bladder ## Footnote Oxybutynin and Tolterodine tartrate are anticholinergic drugs used for overactive bladder.
38
What is the recommended action regarding **fluid intake** for patients on Sulfa Drugs?
Increase fluid intake ## Footnote This is advised to help prevent potential complications.
39
Oxybutynin chloride (Ditropan) is used for **overactive bladder**. What type of drug is it?
Anticholinergic ## Footnote Oxybutynin and Tolterodine tartrate are both anticholinergic drugs for this condition.
40
Which adverse effect should the nurse monitor for in a patient taking **Spironolactone**?
Hyperkalemia ## Footnote Spironolactone is a potassium-sparing diuretic, increasing the risk of high potassium levels.
41
Phenazopyridine (Pyridium) causes a harmless side effect of **discoloration of urine and tears**. True or False?
TRUE ## Footnote This side effect is specifically noted with Phenazopyridine.
42
Thiazide diuretics (HCTZ) and Spironolactone are often prescribed together to maximize BP reduction while managing _______.
potassium levels ## Footnote This combination helps prevent potassium imbalances.
43
Which insulin has an **onset of action** within 15 minutes?
Insulin Aspart (Novolog) ## Footnote Rapid-acting insulins like Insulin aspart and lispro have this quick onset.
44
NPH Insulin is classified as a(n) _______.
Intermediate Acting ## Footnote NPH Insulin is specifically noted as intermediate acting.
45
Insulin Detemir (Levemir) and Insulin Glargine (Lantus) have a unique characteristic of _______.
slow, steady release over 24+ hours ## Footnote These long-acting insulins cannot be mixed with other insulins.
46
Rapid-Acting Insulin (e.g., Lispro) should be administered _______ in relation to the patient's meal.
Within 15 minutes of the meal ## Footnote This timing is crucial for effective blood sugar management.
47
Regular Insulin typically reaches its **peak time** in _______.
1-5 hours ## Footnote This is the peak time for Short Acting (Regular Insulin).
48
The daily maximum recommended dose of **Acetaminophen** is _______.
3,000 to 4,000 mg ## Footnote It is recommended to stay closer to 3,000 mg unless otherwise directed.
49
NSAIDs like Ibuprofen should be taken with food primarily to reduce the risk of _______.
GI bleed/upset stomach ## Footnote This is specifically noted to prevent gastrointestinal issues.
50
A patient taking Morphine should be monitored for which key side effects of **Opioids**? (Select all that apply)
* Constipation * CNS depression * Hypotension ## Footnote These are common side effects associated with opioid use.
51
Gabapentin (Neurontin) is classified as a(n) _______.
Anticonvulsant ## Footnote Gabapentin is specifically listed under anticonvulsants.
52
Antidepressants (Tricyclics) are sometimes used for pain management, especially for _______.
Neuropathic pain ## Footnote They are often used to treat nerve pain.
53
COX-2 Inhibitors (e.g., Celecoxib) are used for pain and inflammation because they inhibit the _______.
COX-2 enzyme necessary for prostaglandin synthesis ## Footnote This inhibition is crucial for their anti-inflammatory effects.
54
The primary caution regarding mixing insulin involves which long-acting type?
Insulin Glargine (Lantus) ## Footnote It is noted that Lantus should not be mixed with any other insulin.
55
The peak time for intermediate-acting NPH insulin is _______.
6-14 hours ## Footnote This is the peak time for NPH insulin.
56
Which symptom is a major concern when administering an **Opioid**?
Bradypnea ## Footnote Slowed breathing is a life-threatening effect due to CNS depression.
57
Unlike NSAIDs, **Acetaminophen** does not have which property?
Anti-inflammatory ## Footnote Acetaminophen is not classified as an anti-inflammatory but does relieve pain and fever.
58
What is the normal total range for a **White Blood Cell (WBC)** count?
5,000 to 10,000 mm^3 ## Footnote This range is considered normal for WBC counts.
59
Which type of WBC is the main cell involved in **phagocytosis** and is usually elevated during a bacterial infection?
Neutrophils ## Footnote Neutrophils engulf particles and their immature forms elevate in a left shift.
60
An elevation in **Lymphocytes** to a higher percentage is commonly referred to as a _______.
Right shift ## Footnote This indicates a viral infection.
61
Which type of WBC is responsible for allergic responses and **parasitic infections**?
Eosinophils ## Footnote Eosinophils play a key role in these immune responses.
62
The primary function of **Lymphocytes** is _______.
Antibody (B-cells) and cell-mediated (T-cells) immunity ## Footnote Lymphocytes are crucial for immune responses.
63
The nurse must monitor for which two major toxicities when administering an **Aminoglycoside**?
* Renal toxicity * Vestibular/Auditory toxicity ## Footnote These are significant risks associated with aminoglycosides.
64
For **Aminoglycosides**, when are peak and trough levels typically measured?
After the 2nd or 3rd dose ## Footnote This timing is crucial for effective monitoring.
65
Cephalosporins inhibit enzymes in the cell wall of susceptible bacteria, making them _______.
Bactericidal ## Footnote This action causes the bacteria to die.
66
A patient with a known allergy to **Penicillin** may have a potential for cross-sensitivity to which other antibiotic class?
Cephalosporins ## Footnote The mechanism of action is similar, indicating a risk for cross-allergy.
67
Which generation of **Cephalosporins** includes Ceftriaxone?
Third generation ## Footnote Ceftriaxone is specifically listed as a third-generation cephalosporin.
68
Aminoglycosides, such as Gentamicin, inhibit _______ by binding to the 30S ribosome.
Bacterial protein synthesis ## Footnote This is the primary action of aminoglycosides.
69
Which is a common side effect of most **antibiotics**?
GI distress (nausea, diarrhea) ## Footnote Common side effects include gastrointestinal issues.
70
The nurse is concerned about a **Left Shift**. This refers to an elevation in _______.
Bands (immature neutrophils) ## Footnote A left shift indicates a bacterial infection.
71
Monocytes are large WBCs that become _______.
Macrophages ## Footnote They function in the destruction of foreign antigens.
72
Which is a serious side effect to monitor for with **Sulfamethoxazole/Trimethoprim (Bactrim)**?
Anaphylaxis/allergy and rash ## Footnote These are critical side effects to be aware of.
73
A major patient education point for all **antibiotics** is to _______.
Take them exactly as the doctor tells you ## Footnote This is crucial for effective treatment.
74
Which type of WBC is the **least abundant**?
Basophils ## Footnote Basophils have the smallest reference range.
75
A key principle regarding **antibiotic resistance** is that _______.
Many resistant bacteria can still be treated with Penicillin ## Footnote This highlights the ongoing effectiveness of Penicillin in some cases.
76
The WBC responsible for the immediate immune reaction and production of **histamine** is the _______.
Basophil ## Footnote Basophils produce histamine during inflammatory reactions.
77
The mnemonic used to remember the relative abundance of WBCs (greatest to least) is _______.
Never Let Monkeys Eat Bananas ## Footnote This corresponds to Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils.
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