NURS-6521 Advanced Pharmacology quiz

NURS-6521 Advanced Pharmacology quiz

NURS-6521 Advanced Pharmacology quiz

NURS-6521 Advanced Pharmacology quiz

A home health nurse notes that there have been changes to a patient’s oral drug regimen. The nurse will closely monitor the new drug regimen to

Response Feedback:    correct

Changes in the drug regimen may cause changes in drug absorption and thereby decrease the anticipated drug effect. This decrease is due to the prevention of binding and loss of absorption and overall drug effectiveness. A change in the drug regimen would not help a nurse to track the route of metabolism or determine the speed of chelation. If any adverse effect were to occur as a result of a drug regimen change, it would not necessarily be immunotoxicity; it could also be nephrotoxicity, ototoxicity, or cardiotoxicity.

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In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient’s hypertension?

Response Feedback: correct

A synergistic effect occurs when two or more “unlike” drugs (in terms of therapeutic effect or mechanism of action) are used together to produce a combined effect, and the outcome is a drug effect greater than either drug’s activity alone. As a result, the patient’s hypertension may be better treated than with a single drug. This does not necessarily reduce the risk of adverse reactions or increase compliance with the regimen.

A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?

Response Feedback:

Unlike oral medications, drugs that are given intravenously do not initially pass through the liver. As a result, the first-pass effect is mitigated and more of the drug is available to cells. Frequent oral doses, low protein intake, and administration with food do not reduce the first-pass effect NURS-6521 Advanced Pharmacology quiz. Correct

 

The nurse is caring for a patient receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity?

Response Feedback:    correct

Decreased urinary output, elevated blood urea nitrogen, increased serum creatinine, altered acid–base balance, and electrolyte imbalances can occur with nephrotoxicity. Ringing noise in the ears (tinnitus) is an indication of possible ototoxicity. Visual disturbances can suggest neurotoxicity, and yellowing of the skin (jaundice) is a sign of hepatotoxicity.

 

A nurse is instructing a patient concerning a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety?

Response Feedback:    correct

If patients are aware of certain adverse effects and how to alleviate or decrease the discomfort, they are more likely to continue taking the medication and providing for safe administration. A list of pharmacies can be useful information, but will not improve safety or compliance. Knowing the cost of the brand versus the generic could also be helpful to the patient. However, a substitution may not be allowed, and the cost of a drug does not improve patient safety. Most patients are not concerned with statistics regarding drug testing, and the testing is usually not discussed with patients.

 

An unconscious patient has been brought to the hospital, and the physician has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication?

Response Feedback:    correct

Intravenous infusion is the preferred method for use in emergency situations when rapid drug effects are desired. Absorption is considered to be instantaneous, as the drug is placed directly into the bloodstream. The subcutaneous and intramuscular routes could be used but would not ensure rapid drug effects. Intrathecal administration is usually done by a physician or a specially trained health care provider.

A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of

Response Feedback:

The incidence of hypertension is significantly higher among African-Americans than other ethnic groups. As well, African Americans respond to some antihypertensive drugs differently than whites.  Correct

 

n which of the following patients would a nurse expect to experience alterations in drug metabolism?

Response Feedback:    correct

The liver is the most important site for drug metabolism. If the liver is not functioning effectively, as with cirrhosis, drugs will not be metabolized normally and toxic levels could develop. Drug dosage will have to be altered to ensure normal levels in the body. The patient with kidney stones and the patient in acute renal failure would most likely have alterations in drug excretion. If there are no complications with the cervical cancer patient, there should be no alterations in drug therapy NURS-6521 Advanced Pharmacology quiz.

During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives

Response Feedback:

Long-term intake of laxatives, antidepressants, and antibiotics has been found to deprive a person of most essential nutrients, such as vitamins. Prolonged use of laxatives is not known to turn urine acidic, cause urinary tract infections, counter the effect of other drugs, or inhibit the biotransformation of drugs. correct

A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient’s medication regimen. Which of the patient’s medications should prompt the nurse to teach her to avoid drinking grapefruit juice?

Response Feedback:    correct

Metabolism of many varied drugs such as calcium channel blockers (used to treat hypertension), statins (used to lower blood lipid levels), and antihistamines (used to prevent allergic reactions) is affected by grapefruit juice.

 

A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to

Response Feedback:    correct

The first-pass effect involves drugs that are given PO and absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. Once in the liver, enzymes break the drug into metabolites; they may become active or may be deactivated and readily excreted from the body NURS-6521 Advanced Pharmacology quiz. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for this phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.

A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?

Response Feedback:

Efficacy indicates how well a drug produces its desired effect. Different drugs have different strengths of attraction or affinity for receptor sites. A drug’s ability to stimulate its receptor is called its intrinsic activity, and the amount of a drug that must be given to produce a particular response is called the potency of a drug.correct NURS-6521 Advanced Pharmacology quiz

A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the patient’s care, the nurse should consider a possible alteration in which of the following aspects of pharmacokinetics?

Response Feedback:

Because absorption takes place mostly in the small intestine, there could be possible alterations with this process. Distribution takes place in the blood vessels; metabolism in the liver; and elimination via the kidneys. Because these systems are not affected by her surgery, these phases of pharmacokinetics would not be altered. Correct

 

In order to promote therapeutic drug effects, the nurse should always encourage patients to

Response Feedback:

Taking a drug at the appropriate time will help the patient maintain therapeutic drug levels. Not all medications should be taken with food, which can alter the absorption of some drugs. A patient should never increase or decrease a medication dosage without checking with the prescriber. Alternative therapy should only be used if the patient has discussed the therapy with the prescriber and they are in agreement. Correct

 

Talwin given in combination with Vistaril diminishes the adverse effects of nausea caused by the Talwin. This drug interaction affecting the pharmacodynamics of the Talwin is

Response Feedback:    incorrect

An antagonistic drug interaction results in a therapeutic effect that is less than the effect of either drug alone because the second drug either diminishes or cancels the effects of the first drug. An additive effect occurs when two or more “like” drugs are combined and the result is the sum of the drugs’ effects. A synergistic effect occurs when two or more “unlike” drugs are used together to produce a combined effect and the outcome is a drug effect greater than either drug’s activity alone. Potentiation is an interaction in which the effect of only one of the two drugs is increased.

 

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NURS-6521N-19,Advanced Pharmacology.2016 Fall Qtr 08/29-11/20-PT27    Quizzes  Review Test Submission: Week 1 – Quiz

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Review Test Submission: Week 1 – Quiz

User     Judy Thiessen

Course NURS-6521N-19,Advanced Pharmacology.2016 Fall Qtr 08/29-11/20-PT27

Test     Week 1 – Quiz

Started            9/2/16 12:36 AM

Submitted        9/2/16 5:34 AM

Status  Needs Grading

Attempt Score 32 out of 40 points

Time Elapsed  4 hours, 57 minutes out of 1 hour and 40 minutesOVER TIME

Instructions

Please answer each question below and click Submit when you have completed the Quiz.

Results Displayed        Feedback

Question 1

1 out of 1 points

A home health nurse notes that there have been changes to a patient’s oral drug regimen. The nurse will closely monitor the new drug regimen to

Response Feedback:

Changes in the drug regimen may cause changes in drug absorption and thereby decrease the anticipated drug effect. This decrease is due to the prevention of binding and loss of absorption and overall drug effectiveness NURS-6521 Advanced Pharmacology quiz. A change in the drug regimen would not help a nurse to track the route of metabolism or determine the speed of chelation. If any adverse effect were to occur as a result of a drug regimen change, it would not necessarily be immunotoxicity; it could also be nephrotoxicity, ototoxicity, or cardiotoxicity.

Question 2

1 out of 1 points

In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient’s hypertension?

Response Feedback:

A synergistic effect occurs when two or more “unlike” drugs (in terms of therapeutic effect or mechanism of action) are used together to produce a combined effect, and the outcome is a drug effect greater than either drug’s activity alone. As a result, the patient’s hypertension may be better treated than with a single drug. This does not necessarily reduce the risk of adverse reactions or increase compliance with the regimen.

Question 3

1 out of 1 points

A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?

Response Feedback:

Unlike oral medications, drugs that are given intravenously do not initially pass through the liver. As a result, the first-pass effect is mitigated and more of the drug is available to cells. Frequent oral doses, low protein intake, and administration with food do not reduce the first-pass effect NURS-6521 Advanced Pharmacology quiz.

Question 4

1 out of 1 points

Tylenol 325 mg/tablet, patient needs 650 mg; how many tables should patient take?

Question 5

1 out of 1 points

The nurse is caring for a patient receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity?

Response Feedback:

Decreased urinary output, elevated blood urea nitrogen, increased serum creatinine, altered acid–base balance, and electrolyte imbalances can occur with nephrotoxicity. Ringing noise in the ears (tinnitus) is an indication of possible ototoxicity. Visual disturbances can suggest neurotoxicity, and yellowing of the skin (jaundice) is a sign of hepatotoxicity.

Question 6

1 out of 1 points

A nurse is instructing a patient concerning a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety?

Response Feedback:

If patients are aware of certain adverse effects and how to alleviate or decrease the discomfort, they are more likely to continue taking the medication and providing for safe administration. A list of pharmacies can be useful information, but will not improve safety or compliance. Knowing the cost of the brand versus the generic could also be helpful to the patient. However, a substitution may not be allowed, and the cost of a drug does not improve patient safety. Most patients are not concerned with statistics regarding drug testing, and the testing is usually not discussed with patients. NURS-6521 Advanced Pharmacology quiz

Question 7

1 out of 1 points

An unconscious patient has been brought to the hospital, and the physician has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication?

Response Feedback:

Intravenous infusion is the preferred method for use in emergency situations when rapid drug effects are desired. Absorption is considered to be instantaneous, as the drug is placed directly into the bloodstream. The subcutaneous and intramuscular routes could be used but would not ensure rapid drug effects. Intrathecal administration is usually done by a physician or a specially trained health care provider.

Question 8

1 out of 1 points

A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of

Response Feedback:

The incidence of hypertension is significantly higher among African-Americans than other ethnic groups. As well, African Americans respond to some antihypertensive drugs differently than whites.

Question 9

1 out of 1 points

In which of the following patients would a nurse expect to experience alterations in drug metabolism?

Response Feedback:

The liver is the most important site for drug metabolism. If the liver is not functioning effectively, as with cirrhosis, drugs will not be metabolized normally and toxic levels could develop. Drug dosage will have to be altered to ensure normal levels in the body. The patient with kidney stones and the patient in acute renal failure would most likely have alterations in drug excretion. If there are no complications with the cervical cancer patient, there should be no alterations in drug therapy.

Question 10

1 out of 1 points

A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient’s medication regimen. Which of the patient’s medications should prompt the nurse to teach her to avoid drinking grapefruit juice?

Response Feedback:

Metabolism of many varied drugs such as calcium channel blockers (used to treat hypertension), statins (used to lower blood lipid levels), and antihistamines (used to prevent allergic reactions) is affected by grapefruit juice.

Question 11

1 out of 1 points

During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives

Response Feedback:

Long-term intake of laxatives, antidepressants, and antibiotics has been found to deprive a person of most essential nutrients, such as vitamins. Prolonged use of laxatives is not known to turn urine acidic, cause urinary tract infections, counter the effect of other drugs, or inhibit the biotransformation of drugs.

Question 12

1 out of 1 points

A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to

Response Feedback:

The first-pass effect involves drugs that are given PO and absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. Once in the liver, enzymes break the drug into metabolites; they may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for this phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.

Question 13

1 out of 1 points

A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?

Response Feedback:

Efficacy indicates how well a drug produces its desired effect. Different drugs have different strengths of attraction or affinity for receptor sites. A drug’s ability to stimulate its receptor is called its intrinsic activity, and the amount of a drug that must be given to produce a particular response is called the potency of a drug.

Question 14

1 out of 1 points

A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the patient’s care, the nurse should consider a possible alteration in which of the following aspects of pharmacokinetics?

Response Feedback:

Because absorption takes place mostly in the small intestine, there could be possible alterations with this process. Distribution takes place in the blood vessels; metabolism in the liver; and elimination via the kidneys. Because these systems are not affected by her surgery, these phases of pharmacokinetics would not be altered.

Question 15

1 out of 1 points

In order to promote therapeutic drug effects, the nurse should always encourage patients to

Response Feedback:

Taking a drug at the appropriate time will help the patient maintain therapeutic drug levels. Not all medications should be taken with food, which can alter the absorption of some drugs. A patient should never increase or decrease a medication dosage without checking with the prescriber. Alternative therapy should only be used if the patient has discussed the therapy with the prescriber and they are in agreement.

Question 16

0 out of 1 points

Talwin given in combination with Vistaril diminishes the adverse effects of nausea caused by the Talwin. This drug interaction affecting the pharmacodynamics of the Talwin is

Response Feedback:

An antagonistic drug interaction results in a therapeutic effect that is less than the effect of either drug alone because the second drug either diminishes or cancels the effects of the first drug. An additive effect occurs when two or more “like” drugs are combined and the result is the sum of the drugs’ effects. A synergistic effect occurs when two or more “unlike” drugs are used together to produce a combined effect and the outcome is a drug effect greater than either drug’s activity alone. Potentiation is an interaction in which the effect of only one of the two drugs is increased.

Question 17

1 out of 1 points

A patient who has ongoing pain issues has been prescribed meperidine (Demerol) IM. How should the nurse best administer this medication?

Response Feedback:

The ventrogluteal site is the preferred site for intramuscular injection. IM injections necessitate the use of a larger gauge needle than is required for subcutaneous injections.

Question 18

1 out of 1 points

A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The nurse suspects that the change in the effectiveness of the drug is related to

Response Feedback:

Antihypertensive drugs work to decrease blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure decreases. If a patient is taking an antihypertensive drug and enters a warmer climate, there is a chance that the patient’s blood pressure will drop too low, resulting in dizziness and a feeling of weakness. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue. Most antihypertensives are metabolized and excreted and do not accumulate in the body. The patient has not given the nurse any information that would indicate that she has not been compliant with her drug regimen due to the move.

Question 19

1 out of 1 points

The nurse’s assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?

Response Feedback:

True allergic reactions include formation of rash or hives, itching, redness, swelling, difficulty breathing, and anaphylactic shock. Nausea and vomiting, however, are adverse effects of drug therapy. Similarly, an unsafe drop in blood pressure and gastric bleeding from aspirin use are adverse drug effects, not allergic reactions.

Question 20

1 out of 1 points

An older adult patient with a history of Alzheimer’s disease and numerous chronic health problems has been prescribed several medications during his current admission to hospital and recent declines in the patient’s cognition have impaired his ability to swallow pills. Which of the following medications may the nurse crush before administering them to this patient?

Response Feedback:

A tablet that is designed for immediate release into the gastric environment is normally safe to crush and administer to the patient. Enteric coated and sustained release tablets may not be crushed because doing so compromising the delayed release into the GI tract that is intended with these medications. Sublingual medications should be placed under the tongue to dissolve rather than swallowed.

Question 21

1 out of 1 points

A patient who has been admitted to the hospital for a mastectomy has stated that she has experienced adverse drug effects at various times during her life. Which of the following strategies should the nurse prioritize in order to minimize the potential of adverse drug effects during the patient’s stay in the hospital?

Response Feedback:

In an effort to minimize the potential of adverse drug effects, it is necessary to closely monitor the patient. It would be inappropriate for the nurse to alter the route or frequency of administration or to encourage herbal remedies that also carry the potential for adverse effects.

Question 22

1 out of 1 points

For which of the following patients would a nasogastric tube most likely be considered to aid in the administration of medications?

Response Feedback:

The use of an NG tube for medication administration requires a functioning GI tract. An NG tube would not be used if a patient is vomiting frequently or has had recent bowel surgery. Similarly, an NG tube would not be used in the case of a competent adult who wishes to discontinue his or her medications.

Question 23

0 out of 1 points

Which of the following statements best defines how a chemical becomes termed a drug?

Response Feedback:

Even though all the responses are correct, a chemical must undergo a series of tests to determine its therapeutic value and efficacy without severe toxicity or damaging properties before it is termed a drug. Test results are reported to the FDA, which may or may not give approval.

Question 24

0 out of 1 points

In response to a patient’s nausea, the nurse has mixed a dose of an antiemetic with 50 mL of sterile normal saline and will administer the dose by IV piggyback. What is the rationale for the use of IV piggyback?

Response Feedback:

When the patient receives continuous IV fluids and is also receiving intermittent IV drug therapy, the drug is normally given through a secondary IV tubing. When a secondary IV tubing is used to administer an IV drug, the tubing is added to the main line tubing, usually at a Y port. Adding secondary tubing is called “piggybacking” because the tubing with the drug rides on top of the primary fluid tubing. Failure to adhere to a prescribed regimen, unstable electrolyte levels, and need for continuous monitoring are not rationales for the use of an IV piggyback.

Question 25

1 out of 1 points

30 ml = _______________tbsp

Question 26

1 out of 1 points

A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration?

Response Feedback:

Triglycerides are the predominant dietary lipids. Fats should supply no more than 25% to 30% of the total intake of a well-balanced diet. It would be most important for the nurse to know the triglyceride level before administration of the fat emulsion and to monitor the levels as appropriate. In the older adult, sodium and potassium levels are important to monitor due to decrease in cardiac function and the likelihood of this patient taking cardiac drugs. Also, due to age it would be important to monitor glucose levels. However, it would be most important in this patient to monitor the triglyceride levels, as well as the cholesterol and phospholipid levels since he or she is to receive a fat emulsion.

Question 27

0 out of 1 points

A nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?

Response Feedback:

Polypharmacy is defined as taking several drugs at the same time. The other options are false statements.

Question 28

0 out of 1 points

A 70-year-old woman is starting on an acidic drug. The nurse is aware that food and nutrient intake can affect drug excretion by changing the urinary pH. About which of the following will the nurse question the patient concerning her diet?

Response Feedback:

The nurse will assess for the amount of meat and vegetables in the woman’s diet. A diet rich in meat or in vegetables may influence the urine pH—either acidic or basic. The renal excretion of drugs may be changed significantly because drugs are generally either weak organic acids or bases. Grapefruit juice and certain drugs may cause an interaction that leads to an increase in bioavailability of the drug, which increases the serum drug level. Diminished protein status results in lower amounts of plasma proteins that can substantially increase the concentration of free drug available. This increase of free drug can increase the drug’s effect and the risk of adverse effects. A significant decrease of dietary sodium can alter the reabsorption of some drugs in the renal tubule, resulting in higher circulating levels of the drug and potential drug toxicity.

Question 29

1 out of 1 points

An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the patient that

Response Feedback:

The nurse should caution the patient against crushing the tablet before ingesting it. Crushing allows an extremely high dose of the drug to be available all at once, instead of being released slowly over time. Severe adverse effects are possible when it is used in this manner. The other options are false statements.

Question 30

1 out of 1 points

Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna’s physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should

Response Feedback:

In patients with moderate dementia, it may be necessary to place the patch on the back where it cannot be removed in settings where a nurse will be reapplying the patch. A patient with moderate dementia would not normally self-manage medications. The dosage of rivastigmine is not increased during a short-term exacerbation of symptoms. Transdermal patches are never applied to mucous membranes.

Question 31

1 out of 1 points

A 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse’s assessment reveals that the patient is being treated for rheumatoid arthritis and hypertension. The patient lives in assisted living and is on a low-sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the patient’s

Response Feedback:

Magnesium hydroxide interacts with many drugs, increasing the effects of some and decreasing the effects of others. Therefore, the nurse should check for drug interactions to avoid adverse effects. Factors such as the patient’s home environment, diet, and activity level should be assessed and could contribute to the patient’s constipation. However, it would be most important to assess the medications that could be affected by the administration of magnesium hydroxide.

Question 32

1 out of 1 points

A 70-year-old woman with a history of atrial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse’s admission assessment, the nurse realizes that the patient has been taking ginkgo biloba supplements in addition to her prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this patient’s care?

Response Feedback:

The woman has experienced an adverse health effect due to the interaction between her prescribed therapy (warfarin) and a herb (ginkgo biloba). The woman’s health problem is not a direct consequence of excessive use of the herb or protein levels and malnutrition.

Question 33

0 out of 1 points

A 90-year-old frail, elderly woman has arrived at the emergency department with a broken hip and in acute respiratory distress. Succinylcholine will be used because of the need for rapid endotracheal intubation, and then the woman will be sent to surgery. Due to the woman’s frail condition, she is at risk for skin breakdown. Which of the following nursing diagnoses would be most appropriate?

Response Feedback:

The nursing diagnosis that directly relates to possible skin breakdown is Impaired Physical Mobility related to drug-induced paralysis. Patients who are unable to speak, move, or breathe unassisted can quickly develop pressure sores (decubitus ulcers). It is the responsibility of the nurse to help keep the patient positioned correctly to avoid skin breakdown. The nurse will plan interventions to prevent skin breakdown based on how long the patient will be immobilized. Impaired Spontaneous Ventilation is related to respiratory paralysis. Fear is related to paralysis and helplessness, and Disturbed Sensory Perception is related to CNS depression secondary to drugs used during anesthesia.

Question 34

1 out of 1 points

A nurse is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following?

Response Feedback:

Desmopressin should be used with caution in patients with conditions associated with fluid and electrolyte imbalance, such as cystic fibrosis or renal or cardiovascular diseases, because these patients are especially prone to hyponatremia. When administered to either pediatric or geriatric individuals, fluid intake should be adjusted downward to limit the risk of hyponatremia and water intoxication. The drug has no effect on the weight or the temperature of the patient. There is no risk for dehydration.

Question 35

1 out of 1 points

An elderly man has been admitted to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease?

Response Feedback:

In male patients, antiandrogens are used to treat prostate cancer. They are not included in treatment of lymphomas, skin cancer, or lung cancer.

Question 36

0 out of 1 points

A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient’s subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication?

Response Feedback:

Digoxin is used to maintain clinical stability and improve symptoms, quality of life, and exercise tolerance in patients with all phases of CHF; it does not decrease mortality from CHF or cure the disease. Digoxin increases urine production but its therapeutic effect is not primarily gained from diuresis or blood pressure reduction NURS-6521 Advanced Pharmacology quiz.

Question 37

1 out of 1 points

Hacioğlu, S. K., Doğu, M. H., Sarı, İ., & Keskin, A. (2015). Successful Treatment of Refractory Gastrointestinal Bleeding by Systemic (Oral) Ankaferd Blood Stopper in a Patient with Glanzmann Thrombasthenia. Balkan Medical Journal, 32(2), 218-220. doi:10.5152/balkanmedj.2015.15734

A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient’s drug therapy?

Response Feedback:

Vascular impairment would have the greatest implication on drug therapy for the patient. Blood flow can affect the rate of absorption. Patients who have impaired circulatory systems absorb drugs less rapidly than those with normally functioning systems. Distribution depends on blood flow to the tissues, the drug’s ability to leave the blood, and the drug’s ability to enter cells. Once a drug is absorbed, it is transported to the tissues and cells through the circulatory system. Pathophysiologic changes in the vascular system impair the distribution of drug molecules, which may decrease the therapeutic effectiveness of the drug. Vascular system impairment can affect liver functioning by decreasing drug metabolism, which can lead to increased circulating levels of the drug, possibly causing more adverse effects. Also, vascular system impairment can affect the capillary network and could lead to increased circulating blood levels of a drug. This could cause more adverse effects to occur. The other variables such as mild hypertension and chronic arthritis should also be considered but would not strongly affect drug therapy. Dietary habits would not significantly affect this patient’s drug therapy NURS-6521 Advanced Pharmacology quiz.

Question 38

1 out of 1 points

A 79-year-old woman has been admitted to the hospital with a gastrointestinal bleed. She is currently receiving a transfusion of packed red blood cells as well as an infusion of pantoprazole (Protonix), a proton-pump inhibitor, to help stop her bleeding. What care setting is most appropriate for this patient?

Response Feedback:

Blood transfusions and continuous infusions of intravenous medications require the vigilant assessment and monitoring that can be provided in an acute care setting; this is not normally possible in an ARU or transitional care setting and would be impossible in an outpatient environment.

Question 39

1 out of 1 points

A 66-year-old woman has a complex medical history that includes poorly-controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman’s medication regimen. The nurse should consequently assess for signs and symptoms of

Response Feedback:

Spironolactone (Aldactone) and eplerenone (Inspra) are potassium-sparing diuretics, so their use increases serum potassium levels NURS-6521 Advanced Pharmacology quiz. Spironolactone is not known to contribute to dysrhythmias, leukocytosis, or thrombophlebitis.

Question 40

0 out of 1 points

A nurse is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the nurse to monitor for

Response Feedback:

Ototoxicity can occur with rapid intravenous administration, especially in patients with poor renal function and in those receiving high doses of furosemide. Although usually transient, ototoxicity may result in permanent damage. Rapid infusions of high-dose furosemide would not place the patient at risk for hepatic encephalopathy. Excessive diuresis from furosemide can result in dehydration and vascular thrombosis, but they would not be the priority in this case NURS-6521 Advanced Pharmacology quiz.

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