Drug Guide Test Bank 1

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____	1.	The nurse is providing care for a patient scheduled to take Precose (acarbose) 25 mg three times daily with meals. The patient reports feeling sweaty, weak, and tremulous. Which of the following actions by the nurse is best?
A.	Reassure the patient that these are common side effects with the medication.	
B.	Call the pharmacy to report an adverse drug reaction.	
C.	Check the patient’s blood glucose level.	
D.	Determine if the patient has a history of anemia.	

____	2.	While responding to a rapid response called on the cardiac step-down unit, the nurse from intensive care observes the unit nurse massaging a patient’s neck and instructing the patient to bear down. Which of the following medications will most likely be used if the patient’s pulse does not return to normal?
A.	Adenocard (adenosine)	
B.	Adrenaline (epinephrine)	
C.	Tenormin (atenolol)	
D.	Saphris (asenapine)	

____	3.	The nurse is instructing the parent of a 6-year-old patient recently started on a ProAir HFA (albuterol) inhaler for exercise-induced asthma. The nurse recognizes that further teaching is necessary by which of the following client statements?
A.	“He may feel like his heart is racing after he takes his inhaler.”	
B.	“He can use the inhaler as many times during football practice as he needs it.”	
C.	“He should avoid cola and other caffeinated drinks since they may increase his heart rate.”	
D.	“He should take two puffs about 15 minutes before gym class.”	

____	4.	While providing care for an adolescent patient newly prescribed Elavil (amitriptyline), the nurse would be most concerned by which of the following patient statements?
A.	“My mouth seems really dry and I’m thirsty all the time.”	
B.	“I take a nap most afternoons now because I feel sleepy sometimes.”	
C.	“I’m not sure why we should even bother anymore; everything seems so pointless.”	
D.	“I drink a cup of coffee most days with breakfast.”	

____	5.	The nurse is caring for a patient with otitis media who reports an allergy to penicillin. Orders are received for ampicillin 500 mg every 8 hr. Which of the following actions by the nurse is best?
A.	Provide the medication as ordered.	
B.	Call the pharmacist to request a substitution.	
C.	Ask the patient if he or she has taken ampicillin in the past.	
D.	Hold the medication.	

____	6.	While caring for a patient in hospice who is actively dying, the nurse notes moderate respiratory distress, copious oral secretion, and a frequent moist cough. Which of the following prn medications would most promote comfort for the patient?
A.	Morphine (morphine sulfate) 2 mg IV bolus	
B.	Atro-Pen (atropine) 0.4 mg IV bolus	
C.	Ativan (lorazepam) 0.5 mg IV bolus	
D.	Benadryl (diphenhydramine) 25 mg IV bolus	

____	7.	The nurse is counseling a patient started on Zithromax (azithromycin) for the treatment of an upper respiratory infection. The nurse recognizes that teaching has been effective by which of the following patient statements?
A.	“The med pack will have five pills, one for each of the next 5 days.”	
B.	“If I don’t feel better next week, I can get a refill from the pharmacist.”	
C.	“I only need to take one pill, but my symptoms may not clear for 3 days.”	
D.	“I can take this medication safely even though I’m allergic to erythromycin.”	

____	8.	The home care nurse is preparing to see a patient being treated for diabetic foot ulcerations with Regranex (becaplermin). Which of the following instructions will the nurse include in the patient teaching?
A.	“Apply the wound gel three times daily to promote healing.”	
B.	“Store the gel in the refrigerator.”	
C.	“Complete healing is expected within 3 days.”	
D.	“After applying the wound gel, cover with a transparent adhesive dressing.”	

____	9.	The nurse is tracking patient symptoms related to acute alcohol intoxication and withdrawal. Which of the following medications would the nurse expect to provide in the management of these symptoms?
A.	Plavix (clopidogrel)	
B.	Zyban (bupropion)	
C.	Prilosec (omeprazole)	
D.	Tranxene (clorazepate)	

Matching

Match the instructions for using an inhaler in the following section with the number they should occur in.
A.	Press down on the inhaler to release medication.	
B.	Hold your breath for 10 sec.	
C.	Shake the inhaler.	
D.	Tilt your head back and breathe out slowly.	
E.	Breathe in slowly through the mouth.	
F.	Connect the inhaler to a spacer/chamber.	

____	235.	Step 3

____	236.	Step 4

____	237.	Step 5

____	238.	Step 6

Sequencing

	239.	Place the following steps in proper sequence to provide 12 units NPH insulin and 4 units regular insulin.
A. Draw up 12 unit NPH insulin.
B. Draw up 4 units regular insulin.
C. Administer subcutaneous injection.
D. Select and prep the site.
E. Mix NPH insulin vial by rotating briskly between hands.
F. Verify order and current accu check result.

	240.	Place the following steps in the correct order for the nurse to provide Prevacid (lansoprazole) 15 mg capsule qd through an NG tube.
A. Flush NG tube with 20 mL water.
B. Check chest x-ray results to verify NG tube placement.
C. Flush NG tube with 20 mL water or apple juice.
D. Open capsule and mix contents with 40 mL apple juice.
E. Inject medication mixture through the NG tube.
F. Aspirate NG tube and check pH of aspirate.

Drug Guide Test Bank 1
Answer Section

MULTIPLE CHOICE

	1.	ANS:	C
See Acarbose Nursing Implications: Observe the patient for signs and symptoms of hypoglycemia. Acarbose alone does not cause hypoglycemia; however, other concurrently administered hypoglycemic agents may produce hypoglycemia requiring treatment. Ignoring these symptoms would be dangerous, but it is not considered an adverse drug reaction requiring an official report. The patient is experiencing symptoms of hypoglycemia not anemia.

PTS:	1	DIF:	Medium	REF:	Page 96	
TOP:	Therapeutic Classification: Antidiabetic		KEY:	Cognitive Level: Analysis

	2.	ANS:	A

	Feedback	
A	See Adenosine Indications: Adenosine is used for the conversion of paroxysmal supraventricular tachycardia (PVST) to normal sinus rhythm when vagal maneuvers are unsuccessful.	
B	Epinephrine is a bronchodilator used in the management of reversible airway disease.	
C	Atenolol is a beta blocker used in the management of hypertension.	
D	Asenapine is an antipsychotic mood stabilizer used in the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar I disorder.	

PTS:	1	DIF:	Medium	REF:	Page 110 | Page 488 | Page 191 | Page 185
TOP:	Therapeutic Classification: Anti-arrhythmic		KEY:	Cognitive Level: Application

	3.	ANS:	B

	Feedback	
A	See Albuterol Contraindications/Precautions, Interactions, and Dosage.	
B	Excess inhaler use may lead to tolerance and paradoxical bronchospasm.	
C	Use with caffeine-containing herbs (cola nut, guarana, tea, coffee) increases stimulant effect. 	
D	Two inhalations every 4–6 hr or two inhalations 15 min prior to exercise. Tachycardia is an expected side effect with this medication.	

PTS:	1	DIF:	Easy	REF:	Pages 117-118		
TOP:	Therapeutic Classification: Bronchodilator		KEY:	Cognitive Level: Analysis

	4.	ANS:	C

	Feedback	
A	Dry mouth is an expected side effect.	
B	Sedation is an expected side effect.	
C	See Amitriptyline Precautions: the use of this medication may increase the risk of suicide attempt/ideation especially during dose early treatment or dose adjustment; risk may be greater in children or adolescents.	
D	There is no directive to avoid caffeine with this medication. 	

PTS:	1	DIF:	Medium	REF:	Pages 142-143		
TOP:	Therapeutic Classification: Antidepressant		KEY:	Cognitive Level: Analysis

	5.	ANS:	D
See Ampicillin Contraindications/Precautions: Contraindicated in hypersensitivity to penicillin. This medication should be held due to the stated allergy to penicillin.

PTS:	1	DIF:	Easy	REF:	Page 156	
TOP:	Therapeutic Classification: Antibiotic		KEY:	Cognitive Level: Application

	6.	ANS:	B

	Feedback	
A	Morphine is used for pain control.	
B	See Atropine Action: Low doses decrease sweating, salivation, and respiratory secretions.	
C	Lorazepam is used for anxiety. 	
D	Benadryl is used for itching. 	

PTS:	1	DIF:	Medium	REF:	Page 195	
TOP:	Therapeutic Classification: Anti-arrhythmic | Therapeutic Classification: Anticholinergic
KEY:	Cognitive Level: Analysis

	7.	ANS:	A

	Feedback	
A	See Azithromycin Route/Dosage: 500 mg on 1st day, then 250 mg/day for 4 more days.	
B	Instruct the patent to notify health care professional if symptoms do not improve.	
C	Teach the patient to take medication as directed and to finish the drug completely.	
D	Azithromycin is contraindicated in patients with an allergy to erythromycin.	

PTS:	1	DIF:	Easy	REF:	Page 202	
TOP:	Therapeutic Classification: Antibiotic		KEY:	Cognitive Level: Analysis

	8.	ANS:	B

	Feedback	
A	See Becaplermin Implementation: Calculated amount is applied as a thin layer and covered with a moist saline dressing for 12 hr; dressing is removed, ulcer rinsed, and redressed with moist dressing without becaplermin for rest of day. Process is repeated daily.	
B	Store gel in refrigerator; do not freeze.	
C	If ulcer does not decrease in size by 30% within 10 wk, continuation of therapy should be reassessed.	
D	Cover with a moist saline dressing for 12 hr. Then, remove dressing, rinse ulcer, and redress with moist dressing without becaplermin for rest of day.	

PTS:	1	DIF:	Hard	REF:	Page 210	
TOP:	Therapeutic Classification: Therapeutic wound | Therapeutic Classification: Ulcer | Therapeutic Classification: Decubiti healing agent	KEY:	Cognitive Level: Analysis

	9.	ANS:	D

	Feedback	
A	Clopidogrel is an antiplatelet agent.	
B	Bupropion is an antidepressant.	
C	Omeprazole is an antiulcer agent.	
D	Clorazepate is used in the management of simple partial seizures, anxiety disorder, symptoms of anxiety, and acute alcohol withdrawal. 	

PTS:	1	DIF:	Medium	REF:	Page 1345	
TOP:	Therapeutic Classification: Anticonvulsant		KEY:	Cognitive Level: Application

	10.	ANS:	B
See Colchicine Nursing Considerations. In patients receiving prolonged therapy, monitor baseline and periodic CBC; may cause decreased platelet count, leukopenia, aplastic anemia, and agranulocytosis. No alteration in the blood pressure, triglyceride, or oxygenation is expected.

PTS:	1	DIF:	Hard	REF:	Page 334	
TOP:	Therapeutic Classification: Antigout			KEY:	Cognitive Level: Application

MATCHING

	235.	ANS:	D	PTS:	1	DIF:	Medium	REF:	Appendix D
TOP:	Therapeutic Classification: Respiratory inhalant	KEY:	Cognitive Level: Application

	236.	ANS:	A	PTS:	1	DIF:	Medium	REF:	Appendix D
TOP:	Therapeutic Classification: Respiratory inhalant	KEY:	Cognitive Level: Application

	237.	ANS:	E	PTS:	1	DIF:	Medium	REF:	Appendix D
TOP:	Therapeutic Classification: Respiratory inhalant	KEY:	Cognitive Level: Application

	238.	ANS:	B	PTS:	1	DIF:	Medium	REF:	Appendix D
TOP:	Therapeutic Classification: Respiratory inhalant	KEY:	Cognitive Level: Application

SEQUENCING

	239.	ANS:	
F, E, B, A, D, C

See Implementation Insulin Intermediate-acting. It is important with all medication administration that the order be verified. The current blood sugar result should be determined for safety to prevent hypoglycemia. Roll intermediate-acting insulin vial between palms to mix, rather than shaking (may cause inaccurate dose). Completing this step before drawing up any insulin will decrease the need to recap the needle between vials. When mixing insulins, draw regular insulin, insulin aspart, insulin glulisine, or insulin lispro into syringe first to avoid contamination of regular insulin vial. The site should be selected and prepped prior to administration

PTS:	1	DIF:	Medium	REF:	Pages 684-685		
TOP:	Therapeutic Classification: Insulins			KEY:	Cognitive Level: Application

	240.	ANS:	
B, F, A, D, E, C

See Lansoprazole Implementation. Prior to giving anything into an NG tube, placement must be verified via chest x ray. Prior to medication administration, exact placement should be checked by aspirating stomach contents and checking the pH of the aspirate; flush the NG tube with water after this procedure. For patients with an NG tube getting Prevacid, capsules may be opened and intact granules may be mixed in 40 mL of apple, cranberry, grape, orange, pineapple, prune, or V8 vegetable juice and injected through the NG tube into stomach. Flush NG tube with additional apple juice to clear tube.

PTS:	1	DIF:	Medium	REF:	Pages 741-742		
TOP:	Therapeutic Classification: Antiulcer		KEY:	Cognitive Level: Analysis

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