1. A patient taking a calcium channel blocker is seen in the clinic and diagnosed with drug
toxicity. When collecting the nursing history, what finding would indicate the likely cause of this
drug toxicity?
A) Intake of alcohol
B) The use of eggs in the diet
C) The ingestion of grapefruit juice
D) Intake of aged cheese
Ans: C Feedback: The calcium channel blockers are a class of drugs that interact with grapefruit
juice. When grapefruit juice is present in the body, the concentrations of calcium channel
blockers increase, sometimes to toxic levels. Advise patients to avoid drinking grapefruit juice
taking a calcium channel blocker. If a patient on a calcium channel blocker reports toxic effects,
ask whether he or she is drinking grapefruit juice. Use of alcohol could be important if the
patient was ingesting large amounts, but that would not be the most likely cause of drug toxicity.
Eggs and cheese should not exert any fooddrug interaction.
2. The health care provider is planning to discontinue a client's beta blocker. What instruction
should the nurse give the client regarding the beta blocker?
a. The beta blocker should be abruptly stopped when another cardiac drug is prescribed.
b. The beta blocker should NOT be abruptly stopped; the dose should be tapered down.
c. The beta blocker dose should be maintained while taking another antianginal drug.
d. Half the beta blocker dose should be taken for the next several weeks.
Ans: B Feedback: The beta blocker should NOT be abruptly stopped; the dose should be tapered
down.
3. The nurse is providing drug teaching for a patient who is prescribed Captopril. What drug
specific adverse effect will the nurse include in the drug teaching?
A) Sedation
B) Persistent cough
C) Tachycardia
D) Rash
Ans: B Feedback: Benazepril, enalapril, and fosinopril are generally well tolerated but cause an
unrelenting cough, possibly related to adverse effects in the lungs, where the angiotensinconverting enzyme is inhibited, which may lead patients to discontinue the drug. This persistent
cough develops in approximately 10% to 20% of patients.
4. When a client first takes a nitrate, the nurse expects which symptom that often occurs?
a. Nausea and vomiting
b. Headaches
c. Stomach cramps
d. Irregular pulse rate
Ans: b Feedback:
5. What drug is a safe and effective calcium channel blocker only if the nurse administers them
as sustained-release or extended-release preparations to treat hypertension?
A) Aliskiren (Tekturna)
B) Diltiazem (Cardizem)
C) Atenolol (Tenormin)
D) Metoprolol (Lopressor)
Ans: B Feedback: The calcium channel blockers available in immediate-release and sustainedrelease forms that are used in treating hypertension include amlodipine (Norvasc), felodipine
(Plendil), isradipine (DynaCirc, DynaCirc CR), and nicardipine (Cardene, Cardene SR). Other
calcium channel blockers are safe and effective for this use only if they are given as sustainedrelease or extended-release preparations. These include diltiazem (Cardizem, Dilacor CR),
nifedipine (Procardia XL), nisoldipine (Sular), and verapamil (Calan SR). Aliskiren (Tekturna) is
a renin inhibitor. Atenolol (Tenormin) and Metoprolol (Lopressor) are beta-blockers, not calcium
channel blocker
6. A client is taking digoxin (Lanoxin) 0.25 mg and furosemide (Lasix) 40 mg. When the nurse
enters the room, the client states, "There are yellow halos around the lights." Which action will
the nurse take?
a. Evaluate digoxin levels.
b. Withhold the furosemide
c. Administer potassium.
d. Document the findings and reassess in 1 hour.
Ans: A. Feedback: Bradycardia
Arrhythmias, Mental changes, Gynecomastia, Vision changes (halos), Hold for apical HR <60
(digoxin will lower heart rate), Monitor serum levels (0.8-2ng.ml), Monitor potassium
Digoxin is a positive inotropic and negative chronotropic drug 7, meaning that it increases the
force of the heartbeat and decreases the heart rate. The decrease in heart rate is particularly
useful in cases of atrial fibrillation, a condition characterized by a fast and irregular heartbeat.
7. The nurse acknowledges that which condition could occur when taking furosemide?
a. Hypokalemia
b. Hyperkalemia
c. Hypoglycemia
d. Hypermagnesemia
Ans: A
8. A 22 year old female has been prescribed Captopril (Capoten) for hypertention. What
recommendation is likely to be given to the patient?
A. Take this medication 4 hours after a meal, before bedtime.
B. Take it at the same time as an iron supplement
C. Take measures to prevent pregnancy
D. It is important to exercise immediately after taking this medication.
C. Take measures to prevent pregnancy
Ans: C Women of child bearing age should take measures to prevent pregnancy because ace
inhibitors can cause injury and death to the fetus. Medication should be taken 1 hour before or 2
hours after a meal. With acute hypotension it is recommended to start with a low dose at bedtime
but not 4 hours after a meal. Iron decreases the effects of captopril so it is not recommended to
take at the same time of day. Medication can be taken without regard to exercise.
9. The client has been receiving spironolactone (Aldactone) 50 mg/day for heart failure. The
nurse should closely monitor the client for which condition?
a. Hypokalemia
b. Hyperkalemia
c. Hypoglycemia
d. Hypermagnesemia
Ans: B
10. A patient is in the intensive care unit because of an acute myocardial infarction. He is
experiencing severe ventricular dysrhythmias. The nurse will prepare to give which drug of
choice for this dysrhythmia?
A. Diltiazem (Cardizem)
B. Verapamil (Calan)
C. Amiodarone (Cordarone)
D. Adenosine (Adenocard)
Ans:C. Amiodarone (Cordarone)
Rationale: Amiodarone (Cordarone) is the drug of choice for ventricular dysrhythmias according
to the Advanced Cardiac Life Support guidelines. The other drugs are not used for acute
ventricular dysrhythmias.
11. Before administering a dose of an antidysrhythmic drug to a patient, what is the priority
nursing assessment?
A. Measure urine output and specific gravity.
B. Check apical pulse and blood pressure.
C. Evaluate peripheral pulses and level of consciousness.
D. Obtain temperature and pulse oximetry on room air.
B. Check apical pulse and blood pressure.
Antidysrhythmic drugs can cause both hypotension and bradycardia; therefore, it is important to
assess blood pressure and apical pulse before administration.
12. The nurse is reviewing the protocol for administration of IV adenosine (Adenocard). What is
the MOST important nursing intervention to remember when giving this medication?
a. Monitor the infusion site for hematoma.
b. Assess for burning sensation at the IV site.
c. Flush the IV catheter with normal saline.
d. Administer it as a fast IV push.
D Administer it as a fast IV push. Adenosine must be given as rapidly as possible because it has
an extremely short half-life of less than 10 seconds. For this reason, it is administered only IV
and only as a fast IV push.
13. Your patient is taking Simvastatin. Which of the following findings below demonstrate this
medication is providing therapeutic effects to this patient? Select-all-that-apply:
A. HDL 80 mg/dL
B. LDL 72 mg/dL
C. HDL 30 mg/dL
D. LDL 190 mg/dL
The answers are A and B. Statins should lower LDL (the bad cholesterol…..approximate normal
range <100) and increase HDL (the good cholesterol…. approximate normal range >60).
14. A patient comes to the clinic with symptoms as seen in a cold. What group of upper
respiratory drugs causes local vasoconstriction, which decreases blood flow and shrinks swollen
membranes to improve
air flow?
A) Antitussives
B) Decongestants
C) Expectorants
D) Mucolytics
Ans: B
Feedback:
Decongestants cause local vasoconstriction that decreases blood flow to irritated and dilated
capillaries of the mucous membranes lining the nasal passages and sinus cavities. This
vasoconstriction leads to a shrinking of swollen membranes and opens clogged nasal passages
promoting drainage of secretions and improved air flow. Antitussives either work directly on the
medullary cough center of the brain or act as a local anesthetic on the respiratory passages
blocking the effectiveness of the stretch receptors that stimulate a cough reflex. Expectorants
liquefy lower respiratory tract secretions, reducing the viscosity of the secretions and so making
it easier to cough them up. Mucolytics break down mucus to aid a person in coughing up thick
tenacious secretions by separating cells that hold mucous material together
15. A patient presents at the clinic with a dry nonproductive cough. The patient is diagnosed with
bronchitis and it has been determined that assistance is needed in thinning the sputum so the
cough can become productive. What does the nurse expect the physician will prescribe?
A) Benzonatate (Tessalon)
B) Guaifenesin (Mucinex)
C) Dextromethorphan (Benylin)
D) Hydrocodone (Hycodan)
Ans: B Feedback: Because this patient needs to cough up respiratory secretions, he would likely
be prescribed guaifenesin. This drug is an expectorant that liquefies lower respiratory secretions
by reducing their viscosity and so making it easier for a patient to cough them up. Benzonatate,
dextromethorphan, and hydrocodone are antitussives and are given to suppress the cough reflex.
16. A client tells the nurse that he has started to take an OTC antihistamine, diphenhydramine. In
teaching him about side effects, what is most important for the nurse to tell the client?
a. Do not to take this drug at bedtime to avoid insomnia.
b. Avoid driving a motor vehicle until stabilized on the drug.
c. Nightmares and nervousness are more likely in an adult.
d. Limit use to 1 to 2 puffs/sprays 4 to 6 times per day to avoid rebound congestion.
Ans: b. Avoid driving a motor vehicle until stabilized on the drug.
17. The nurse is providing health teaching to a newly diagnosed asthmatic patient. The patient
has been prescribed theophylline. What is contraindicated with the use of this drug?
A) Using insulin
B) Taking anti-inflammatory drugs
C) Exercising
D) Smoking cigarettes
Ans: D Feedback: Nicotine increases the metabolism of xanthines in the liver so that xanthine
dosage must be increased in patients who continue to smoke while using xanthines. In addition,
extreme caution must be used if the patient decides to decrease or discontinue smoking because
severe xanthine toxicity can occur. Bronchoconstriction is not caused by using insulin and antiinflammatory drugs do not cause bronchoconstriction. Exercise with a physician’s supervision is
encouraged in individuals with asthma
18. What action by the patient would indicate that the patient understands how to use an inhaler?
A) The patient inhales as soon as the inhaler enters his or her mouth.
B) The patient holds his or her breath for several seconds after releasing the medication.
C) The patient administers three doses of medication within a 1-minute time frame.
D) The patient exhales as soon as he or she compresses the inhaler.
Ans: B Feedback: Holding the breath prevents exhalation of medication still remaining in the
mouth. The patient should inhale when the canister is compressed, not as soon as the inhaler
enters his or her mouth. The patient should only administer one dose of medication at a time and
the patient should wait to exhale until after the breath has been held as long as possible.
19. A patient has an acute asthma attack. A bronchodilator is used to bring the exacerbation
under control.What drug would be used to prevent acute bronchoconstriction?
A) Salbutamol (Ventolin)
B) Salmeterol (Serevent)
C) Fenoterol (Berotec)
D) Terbutaline (Bricanyl)
Ans: B Feedback: Salmeterol (Serevent) and formoterol (Foradil) and are long-acting beta2adrenergic agonists used only for prophylaxis of acute bronchoconstriction. Options A, C, and D
are all short-acting beta2-adrenergic agonists and not used for prophylaxis.
20. Why are inhaled steroids used to treat asthma and chronic obstructive pulmonary disease
(COPD)?
A) They act locally to decrease release of inflammatory mediators.
B) They act locally to improve mobilization of edema.
C) They act locally to increase histamine release.
D) They act locally to decrease histamine release.
Ans: A Feedback: When administered into the lungs by inhalation, steroids decrease the
effectiveness of the inflammatory cells. This has two effects, which are decreased swelling
associated with inflammation and promotion of beta-adrenergic receptor activity, which may
promote smooth muscle relaxation and inhibit bronchoconstriction. Options B, C, and D are
incorrect.
21. The nursing instructor is talking to a group of nursing students about the treatment regimen
for children with asthma. The students indicate they understand the information when they
identify which class of drugs that comprise this regimen? (Select all that apply.)
A) Long-acting inhaled steroids
B) Xanthines
C) Leukotriene-receptor antagonists
D) Topical steroid nasal decongestants
E) Beta-agonists
Ans: A, C, E Feedback: Antiasthmatics are frequently used in children. The leukotriene-receptor
antagonists have been found to be especially effective for long-term prophylaxis in children.
Acute episodes are best treated with a beta-agonist and then a long-acting inhaled steroid or a
mast cell stabilizer. Xanthines (e.g., theophylline) have been used in children, but because of
their many adverse effects and the better control afforded by newer agents, its use is reserved for
patients who do not respond to other therapies. Topical steroid nasal decongestants may be used
for symptom relief for nasal congestion but are not a regular part of asthma therapy in children.
22. A patient with asthma is going to begin taking an inhaled steroid. The nurse teaching the
patient that what adverse effects may occur when using this drug? (Select all that apply.)
A) Dry mouth
B) Sore throat
C) Sepsis
D) Oropharyngeal candidiasis
E) Depression
Ans: A, B, D Feedback: Adverse effects
Inhaled: hoarseness, dry mouth, sore throat, and oropharyngeal candidiasis PO & IV: CV: fluid
retention, edema, hypertension. Electrolytes: increase Na, Ca, and glucose, decrease potassium.
CNS: mood swings and euphoria. GI: N/V, GI bleed. MS: affects bone reabsorption. Skin: acne,
thin skin, bruising, delay healing, infections. General: weight gain, adrenal suppression,
immunosuppression, the risk for Cushing Syndrome
23. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is
receiving theophylline (Theo-24). The nurse monitors the serum theophylline level and
concludes that the medication dosage may need to be increased if which value is noted?
a) 5 mg/mL
b) 10 mg/mL
c) 15 mg/mL
d) 20 mg/mL
a) 5 mg/mL
Rationale: Theophylline is a bronchodilator. The nurse monitors the theophylline blood serum
level daily when a client is on this medication to ensure that a therapeutic range is present and
monitor for the potential for toxicity. The therapeutic serum level range is 10 to 20 mg/mL. If the
laboratory result indicated a level of 5 mg/mL, the dosage of the medication would need to be
increased.
24. A nurse is preparing to administer albuterol (Proventil HFA) to a client. Which parameters
should the nurse assess before and during therapy?
a) Nausea and vomiting
b) Headache and level of consciousness
c) Lung sounds and presence of dyspnea
d) Urine output and blood urea nitrogen level
c) Lung sounds and presence of dyspnea
Rationale: Albuterol is an adrenergic bronchodilator. The nurse assesses respiratory pattern, lung
sounds, pulse, and blood pressure before and during therapy. The nurse also notes the color,
character, and amount of sputum.
25. The nurse is caring for a patient with abnormal calcium levels. What thyroid hormone does
the nurse expect this will impact?
A) Aldosterone
B) Calcitonin
C) Erythropoietin
D) Insulin
Ans: B Feedback: Calcitonin is produced and secreted by the thyroid gland in direct response to
serum calcium levels. Aldosterone is an adrenocorticoid hormone that is released in response to
adrenocorticotropic hormone. Erythropoietin is released by the juxtaglomerular cells in the
kidney in response to decreased pressure or decreased oxygenation of the blood flowing into the
glomerulus. Insulin is produced by the pancreas in response to varying blood glucose levels
26. A patient is brought to the emergency department with severe hypoglycemia. What drug
would the nurse prepare to administer?
A) Diazole (Hyperstat)
B) Glyburide (DiaBeta)
C) Glucagon (GlucaGen)
D) Insulin (Humulin R)
Ans: C Feedback: This patient will need a glucose-elevating agent. Glucagon (GlucaGen) is
given parenterally only and is the preferred agent for emergency situations. Diazole is also a
glucose-elevating agent but is only administered so it would take longer to take effect. Insulin
would be administered for hyperglycemia. Glyburide is an oral antidiabetic agent, which is a
second-generation sulfonylurea, and is administered for hyperglycemia.
27. A patient is admitted to the emergency department in diabetic ketoacidosis (DKA) with a
blood glucose level of 485 mg/dL. The physician orders an initial dose of 25 U insulin IV.
Which type of insulin will be administered?
A) NPH insulin
B) Humulin L insulin
C) Humulin N insulin
D) Regular insulin
Ans: D Feedback: Regular insulin is a short-acting insulin that manages the hyperglycemia and
hyperkalemia resulting from DKA, which is a life-threatening complication that occurs with
severe insulin deficiency. Furthermore, only regular insulin can be given IV and is the drug of
choice in emergency situations. Humulin N, Humulin L, and NPH are intermediate-acting forms.
28. What antidiabetic agent is approved for the nurse to administer to children 10 years old and
older with type 2 diabetes?
A) Pioglitazone
B) Repaglinide
C) Liraglutide
D) Metformin
Ans: D Feedback: Metformin is the only oral antidiabetic drug approved for children. It has
established dosage for children 10 years of age and older. With the increasing number of children
being diagnosed with type 2 diabetes, the use of other agents in children is being tested. Because
metformin is the only drug approved for use with children, pioglitazone, repaglinide, and
liraglutide would not be appropriate.
29. A physician prescribes levothyroxine sodium (Synthroid), 0.15 mg orally daily, for a client
with hypothyroidism. The nurse will prepare to administer this medication:
a) in the morning to prevent insomnia
b) only when the client complains of fatigue and cold intolerance
c) at various times during the day to prevent tolerance from occurring
d) three times daily in equal doses of 0.5 mg each to ensure consistent serum drug levels
a) in the morning to prevent insomnia
Levothyroxine (Synthroid) is a synthetic thyroid hormone that increases cellular metabolism.
Levothyroxine should be given in the morning in a single dose to prevent insomnia and should
be given at the same time each day to maintain an adequate drug level. Therefore, options B, C,
and D are incorrect.
30. A type I diabetic patient comes to the clinic for a follow-up appointment. The patient is
taking NPH insulin, 30 units every day. A nurse notes that the patient is also taking metoprolol
(Lopressor). What education should the nurse provide to the patient?
A) "You need to increase your insulin to allow for the agonist effects of metoprolol."
B) "Metoprolol may potentiate the effects of the insulin, so the dose should be reduced."
C) "Metoprolol has no effects on diabetes mellitus or on your insulin requirements."
D) "Metoprolol may mask signs of hypoglycemia, so you need to monitor your blood glucose
closely."
Ans: D) "Metoprolol may mask signs of hypoglycemia, so you need to monitor your blood
glucose closely."
31. Your patient’s blood glucose level is 215 mg/dL. The patient is about to eat lunch. Per sliding
scale, you administer 4 units of Insulin Lispro (Humalog) subcutaneously at 1130. As the nurse,
you know the patient is most at risk for hypoglycemia at what time?
A. 1145
B. 1230
C. 1430
D. 1630
The answer is B. If you gave the Lispro at 1130, the patient is at most risk for hypoglycemia 1
hour after administration, which is 1230.
32. The nurse provides information to a client diagnosed with insulin-dependent diabetes
mellitus. Which manifestations resulting from a blood glucose level less than 70 mg/dL (4
mmol/L) should the nurse include in the information? Select all that apply.
A. Hunger
B. Sweating
C. Weakness
D. Nervousness
E. Cool clammy skin
F. Increased urinary output
A, B, C, D, E
Hypoglycemia is characterized by a blood glucose level less than 70 mg/dL (4 mmol/L). Clinical
manifestations of hypoglycemia include hunger, sweating, weakness, nervousness, cool clammy
skin, blurred vision or double vision, tachycardia, and palpitations. Increased urinary output is a
manifestation of hyperglycemia.
33. The client is prescribed insulin lispro 3 times a day with the amount based on blood glucose
levels. Which client statement should indicate to the nurse that the client understood discharge
teaching regarding insulin lispro?
A. "The medication should be administered 1 hour after each meal."
B. "I should spread the 3 daily doses evenly throughout the 24-hour day."
C. "Lispro should be taken at least 1 hour before each of my 3 daily meals."
D. "I will take the lispro 10 to 15 minutes before I eat my daily three meals."
D. "I will take the lispro 10 to 15 minutes before I eat my daily three meals."
Lispro is a rapid-acting insulin analog with an onset of action of 15 minutes. The client should
administer the dose 10 to 15 minutes before eating a meal. Because the drug peaks in ¾ to 1½
hours, it would not be beneficial to wait for 1 hour after the meal to administer it. In addition, if
the lispro is given 1 hour before the meal, the medication will begin to peak before the client's
meal is eaten. Lispro administration should not be spread out through equal time intervals.
34. A patient with newly diagnosed type 1 diabetes is beginning daily insulin injections. The
nurse is preparing to teach the patient about insulin injections. What should the nurse include in
the teaching?
A. Understand that ketones in urine indicate the need for a decrease in number of units of insulin
B. Administer the insulin at the same time every day regardless of meals
C. Rotate the insulin injection sites
D. Increase the insulin dosage just prior to exercise
Ans: C. Lipodystrophy (hypertrophy of subcutaneous tissue at the injection site) can occur when
the clients uses the same injection sites. Hypertrophied tissue can affect the amount or degree to
which subcutaneous insulin is absorbed and thereby affect blood glucose levels
35. Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of
24 hours?
A) insulin glargine (Lantus)
B) insulin glulisine (Apidra)
C) regular insulin (Humulin R)
D) NPH insulin (Humulin N)
A, Insulin glargine has a duration of action of 24 hours with no peaks, mimicking the natural,
basal insulin secretion of the pancreas.
36. What is the expected action of glipizide?
A. Pain relief
B. Lowered heart rate
C. Release of insulin
D. Reduction of fever
ANS: C. Glipizide works to release insulin from the pancreas and increase tissue sensitivity to
insulin over time.
37. The nurse obtains information during the admission interview that the client is taking herbal
supplements. What implications does this information have for the client's treatment?
A. This is not important, as herbal products are natural, and pose no risk to the client.
B.These products are a welcome adjunct to conventional treatment.
C. The nurse must observe the client for allergic reactions.
D. The herbal products could interact with prescribed medications and affect drug action.
Your Answer: D. The herbal products could interact with prescribed medications and affect drug
action.
Objective: Describe some adverse effects that might be caused by herbal preparations.
Rationale: Some herbal products contain ingredients that can serve as agonists or antagonists to
prescription drugs. Herbal supplements should not be taken without discussion with the
physician. Being natural does not guarantee they do not carry risks.
38. The client states he has been using the herbal product saw palmetto. The nurse determines the
product is helpful when the client reports:
A. The ability to fall asleep quickly.
B. Less difficulty initiating urination.
C. A decrease in the frequency of headaches.
D. Less burning and pain with urination.
Your Answer:
B. Less difficulty initiating urination.
Objective: Identify common drug-herbal interactions.
Rationale: Saw palmetto is used to relieve urinary problems related to prostate enlargement, such
as urinary hesitancy, urgency, and a decrease in urinary stream. It does not affect sleep, cause
headaches, or relieve symptoms of a urinary tract infection.
39. A client receiving warfarin (Coumadin) therapy reports use of the herb feverfew. The nurse
observes the client for evidence of:
A. Liver toxicity.
B. Increased coagulation.
C. Renal dysfunction.
D. Increased bleeding potential.
Your Answer:
D. ncreased bleeding potential.
Objective: Identify common drug-herbal interactions.
Rationale: Feverfew can interact with aspirin, heparin, NSAIDs, and warfarin, and can cause
increased bleeding.
40. A nurse is caring for a patient who is considering taking Ginkgo biloba supplements to
improve memory. What information should the nurse provide to the patient?
a) Ginkgo supplements are safe to use concurrently with blood-thinning medications.
b) Ginkgo is effective in preventing memory loss associated with Alzheimer's disease.
c) Patients with a history of seizures should avoid Ginkgo supplementation.
d) Ginkgo can be used without concern for interactions with prescription medications.
ANS: C
41. When teaching a patient who has recently received a diagnosis of diabetes how to selfadminister short acting and intermediate acting insulin subcutaneously, which instructions is
correct?
A. Understand that the order of drawing up the two insulins into the syringe doesn't matter
B. Draw the short-acting insulin in to the syringe 1st, followed by the intermediate acting insulin
C. Draw the intermediate acting insulin into the syringe 1st, followed by the short acting insulin
D. Give yourself two injections bc mixing these insulins together is unsafe
Ans: B. The short-acting insulin (clear) should always be drawn up first because the
intermediate-acting insulin (cloudy) can inversely affect the short-acting insulin if mixed in the
vial. CLEAR DAYS BEFORE CLOUDY!
42. . A female patient tells the nurse that he would like to begin taking St. John's wort for
depression. What teaching should the nurse provide?
A. “St. John's wort should be taken several hours after your other antidepressant.”
B. “St. John's wort has generally been shown to be effective in treating depression.”
C. “This supplement is safe to take if you are pregnant.”
D. “St. John's wort is regulated by the FDA, so you can be assured of its safety.”
ANS: B
43. The nurse is assessing a newly admitted patient who is noted to exhibit unusually low blood
pressure. The patient tells the nurse that he has added herbal medication to his drug regimen.
Based on the symptoms being experienced, the nurse expects that the patient has been taking
which herb?
a. Licorice
b. Milk thistle
c. Hawthorn
d. Sage
Ans: C. Hawthorn
Hawthorn is known to produce hypotension, which treats HTN. Licorice produces an increase in
blood pressure, not a decrease. Garlic is used for antimicrobial, antilipidemic, antithrombotic,
antitumor, and anti-inflammatory. Eucalyptus is used for coughs, bronchitis, nasal congestion,
sore muscles and wounds.
44. Which statement is correct about the synthetic cannabinoid drug Drobabinol FDA?
A.
Used for appetite stimulant and weight gain for AIDS and treatment of Nausea/Vomiting
during cancer therapy
B.
Treatment of Nausea/Vomiting associated with cancer therapy when antiemetics have
failed
C.
Used for pain management during cancer treatment
D.
Is given through IV
ANS: A
45. Which herbal product has been used for the treatment of jet lag?
A. St. John's wort
B. Ginseng
C. Melatonin
D. Ginger
C. Melatonin
Rationale: Melatonin appears to be useful in patients traveling through several time zones and
who are suffering from jet lag. St. John's wort is used for the treatment of depression; it has not
been shown to be effective in treating jet lag. Ginger can be used for motion sickness that may be
experienced when flying, but there is no evidence that it is effective for the treatment of jet lag.
Ginseng has not been shown to be effective in treating jet lag.
46. The patient is prescribed warfarin [Coumadin] to treat deep vein thrombosis. The nurse is
teaching the patient about dietary supplements that have the potential to interfere with coumadin
therapy. What herbs should the nurse include in the teaching? (Select all that apply.)
A Echinacea
B Garlic
C Ginger root
D Gingko biloba
E Hawthorn
ANS: B, C, D
47. The nurse is completing an admission assessment for a patient who requires treatment of an
anxiety disorder. The patient states "I take the dietary supplement kava every day to help my
anxiety and stress." The nurse understands the patient is at risk for which serious adverse effect?
A Stroke
B Hepatoxicity
C Suicidal behavior
D Acute renal failure
ANS:B Hepatoxicity
48. What are the two herbal supplements are combined to use in promoting musculoskeletal
system?
A.
Chondroitin
B.
Capsicum
C.
Glucosamine
D.
Feverfew
ANS: A, C, Collagen synthesis, Used for arthritis for cartilage synthesis (with glucosamine)
MOA (helps to keep cartilage hydrated) Glucosamine: employed by the body in the synthesis of
cartilage and synovial fluid)
49. A patient will begin taking immunosuppressant drugs for rheumatoid arthritis. The nurse will
caution this patient to avoid which dietary supplement?
a.Black cohosh
b.Echinacea
c.Feverfew
d.Glucosamine
B (Echinacea stimulates the immune system so it should not be used in patients with
autoimmune disease such as RA; it also compromises the effectiveness of immunosuppressive
drugs. Black cohosh, feverfew, and glucosamine are not contraindicated in patients with RA.)
50. A patient will begin taking drugs for hyperlipidemia. The patient asks about using flaxseed
supplements to increase fiber. What will the nurse tell this patient?
a.Not to use defatted flaxseed
b.That flaxseed helps with the absorption of medications
c.That flaxseed is not recommended
d.To take the flaxseed one or two hour before taking the drug
D (Flaxseed may reduce the absorption of conventional drugs and should be taken 1 hour prior to
or 2 hours after taking drugs. Defatted flaxseed is not recommended for patients with
hyperlipidemia. It does not help with the absorption of medications. It has shown efficacy in
reducing cholesterol and LDL.)
The antidote to digoxin is digibind, (the only antidote on this exam), digoxin is a cardiac
glycoside and the biggest sign of toxicity are vision changes.
The s/s of hypoglycemia: hunger, sweating, weakness, nervousness, cool clammy skin
Metoprolol can Mask Hypoglycemia (-Eric)
Metformin is the only oral diabetic med
Know the MOA and side effects of all meds
Endocannabinoid System Function and Receptors CB1 + CB2 (-Eric)
When taking Digoxin, know that hypokalemia will increase Digoxin side effects.
The peaks of insulin
Normal serum levels for digoxin.
ACE and ARBs only decrease BP, not HR, also avoid when pregnant, adds potassium
Don’t stop taking corticosteroids abruptly
There is no peak for Long acting Insulin (Glargine, Lantus)
ACE inhibitors: -pril, ARBs: -sartan, alpha blockers: -osin, beta blockers: -lol, calcium channel
blockers: -dipine, diuretics: -ide