Pharm gurus, test your knowledge (multiple choice)

[ZionsWrath]

I have a take home exam for my Pharm class. I want to boost my grade with this so I'm trying to get 100%. It isn't due for like 5 weeks but it is 60 questions and I wanted to do it early.

Below are a few questions I am having difficulty with. The choice I think is the answer is in bold. Any input would be appreciated.

1.What action should the nurse implement to provide analgesic titration for a client in pain?

A.Teach the client to increase the time range between doses of pain medication.

B.Monitor the effects of continuous intravenous infusion of narcotic analgesics.

C.Plan with the client how to use a specific total dose of analgesic over a 24-hour period.

D.Determine the optimal analgesic dosage required that causes the least side effects.

10.Based on the blood culture and sensitivity results, the healthcare provider prescribes an IV aminoglycoside antibiotic and discontinues the current prescription for another broad spectrum antibiotic. The medication administration record indicates that the client received the broad spectrum antibiotic two hours ago. Which action should the nurse implement?

A.Obtain peak and trough serum levels so the aminoglycoside antibiotic can be initiated.

B.Administer the initial dose of the aminoglycoside antibiotic as soon as possible.

C.Withhold antibiotic administration until the healthcare provider clarifies the prescriptions.

D.Schedule the initial dose of the aminoglycoside antibiotic for the following day.

26.A client who takes a statin and gemfibrozil (Lopid) for hyperlipidemia reports onset of muscle pain and weakness. What additional assessment is most important for the nurse to obtain?

A.Serum liver enzymes.

B.T3 and T4 blood levels.

C.Bowel function.

D.Peripheral sensation.

47.A client receives a prescription for esomeprazole (Nexium) for heartburn. Which finding in the client's history should the nurse report to the healthcare provider before administering the prescription?

A.Eats spicy food three times a week.

B.History of deep vein thrombosis.

C.Drinks 2 alcoholic beverages on weekends.

D.Family history of diabetes mellitus.

48.The nurse should expect the healthcare provider to prescribed what treatment regimen for a client with peptic ulcer caused by Helicobacter pylori? (Select all that apply.)

A.Clarithromycin (Biaxin).

B.Sulfisoxazole (Gantrisin).

C.Misoprostol (Cytotec).

D.Omeprazole (Prilosec).

E.Metronidazole (Flagyl).

F.Sucralfate (Carafate).

50.What teaching should the nurse provide a client who has received a new prescription for sildenafil (Viagra)? (Select all that apply.)

A.Frequent use can lead to the development of hypertension.

B.Most effective if taken after at least 6 hours of REM sleep.

C.Take within 30 to 60 minutes of sexual stimulation.

D.Report rebound priapism that occurs for 4 hours or more.

E.Can cause facial flushing and headache.

53.A client receives a new prescription for nitroglycerin (Nitrostat) tablets. Which instruction should the nurse include in this client's teaching?

A.Take the medication at least an hour before every meal.

B.Monitor your pulse for 60 seconds before administration.

C.Place under the tongue as needed every 5 minutes up to 3 times.

D.Resume normal activities after chest pain relief is obtained.

[pharmgirl]

Off the top of my head, the only thing I would add is the priapism with viagra.

[ZionsWrath]

I want to put that as well but I wasn't sure what a "rebound priapism" was. Is it just a priapism?

[pharmgirl]

I didnt particularly like the wording either but whichever way you look at it priapism for 4 hours is never good lol. Good Luck

[ZionsWrath]

Ok, I'll put that too.

Thanks for the input.

[ZionsWrath]

Bump.

Any more input? Agree or disagree with answers?

[TRR8021]

Hi, I'm a student as well, but I was thinking #10 is A. because you would want to know when it peaks before you give another ABx. That's just my guess so I'm not 100% certain. I was also thinking that the two could be contraindicated so you wouldn't want to give them on top of each other if that's the case. There's also the issue of creating bacterial resistance to drugs so I wouldn't want to give 2 kinds of ABx together.

For #26 I would chose D. check peripheral sensations because Lopid can cause parathesia.

For #47 about Nexium, I would chose the ETOH use because alcohol can react with medications and make ulcers worse. Nexium is a proton pump inhibitor so I don't think it has anything to do with DVT's or clot formation.

For #48, I wouldn't chose flagyl because that's usually for GU infections (like gardnerella, trichomoniasis), but the Bioxin is indicated for H.pylori. I would also chose Prilosec like you did.

#50 I would add the rebound priapism.

And I agree that #53 is C.

Hope that helps some!

[dej1327]

Hi, on #48 i wouldn't choose Flagyl, but I would choose F.) Sucralfate because it forms a barrier around the ulcer protecting it from further damage by gastric acid. And i definitely would choose priaprism, too for #50

[ZionsWrath]

Just an update. The answers are now circulating around the student body and all the questions above are correct, the only thing needed to add is the rebound priapism.

Thanks for the help.

[RNKimberly57]

Hi do you still have the answers to this exam? I just finished it and I wanna compare it before i hand it in