Transcript The Pharmacology Review

The Pharmacology Review
Leslie Davis, MSN, RN, CS, ANP
Clinical Associate Professor
UNC CH, School of Nursing
Pharm Review-LDavis-2007
Some Test Taking Tips For the
NCLEX and Beyond
Know your normal lab values! These
can have a Huge Impact on Meds you
may give.
 Know Side Effects to Common Meds
 Know Commonly Prescribed Meds and
what their Therapeutic Use is.

Pharm Review-LDavis-2007
Most important lab values to know
K+ (3.5-5.0)
 Hgb/ Hct
 When to do PT/INR vs. PTT
 Toxic values to know

Digoxin levels > 2.0
 Lithium levels > 2.0
 Dilantin levels > 20.0

Pharm Review-LDavis-2007
Now for the Question & Answer
Portion of the Afternoon…….
Pharm Review-LDavis-2007
Question 1:
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1.
2.
3.
4.
If Regular Insulin is given at 0730am
when is a reaction most likely??
11am
2pm
5pm
9pm
Pharm Review-LDavis-2007
Question 2

1.
2.
3.
4.
Which patient would you be most
concerned with digitalis toxicity?
Patient with constipation
Patient with serum potassium of 4.1
Patient taking HCTZ
Patient taking oral diabetic agents
Pharm Review-LDavis-2007
Question 3
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1.
2.
3.
4.
A patient recently admitted to the ICU is
having frequent premature ventricular
contractions that are symptomatic. Which of
the following medications would you expect
this patient to receive?
Digoxin
Furosemide
Lidocaine
Levophed
Pharm Review-LDavis-2007
Question 4

1.
2.
3.
4.
Which lab value would you monitor
closely with a patient receiving IV
Heparin?
Protrombin time (PT)
Platelet Count
International normalized ratio (INR)
Partial thromboplastin time (PTT)
Pharm Review-LDavis-2007
Question 5

1.
2.
3.
4.
Which Lab Value would you monitor
closely with a patient receiving warfarin
(Coumadin)?
White Blood Cell Count (WBC)
Platelet count
International normalized ratio (INR)
Partial thromboplastin time (PTT)
Pharm Review-LDavis-2007
Question 6

1.
2.
3.
4.
The RN instructs the client taking
warfarin (Coumadin) about interactions.
Which drug could increase the risk of
adverse effects for the client?
Furosemide (Lasix)
Diazepam (Valium)
Digoxin (Lanoxin)
Acetylsalicylic Acid (Aspirin)
Pharm Review-LDavis-2007
Question 7

Your pt is receiving steroid taper of
Prednisone. The pt asks why you can’t stop
the medicine quickly. Your response is:
1.
To avoid systemic toxicity
To facilitate natural adrenocortical
function
To prevent glycosuria
To prevent fluid and electrolyte
imbalance
2.
3.
4.
Pharm Review-LDavis-2007
Question 8
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1.
2.
3.
4.
What is a concern associated with long
term use of diazepam (Valium)?
Decreased ability to maintain balance
Muscle atrophy
Abrupt discontinuation of therapy
Orthostatic hypotension
Pharm Review-LDavis-2007
Question 9
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1.
2.
3.
4.
A pt being treated for bipolar disorder is
receiving Lithium therapy. Which
electrolyte abnormality could cause
toxic effects?
Low potassium
Low sodium
Low calcium
Iron deficiency
Pharm Review-LDavis-2007
Question 10
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1.
2.
3.
4.
Which of the following ENHANCES the
effects of narcotic analgesics?
Naloxone (Narcan)
Flumazenil (Romazicon)
Lidocaine (Xylocaine)
Ethanol (Alcohol)
Pharm Review-LDavis-2007
Question 11
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1.
2.
3.
4.
What is the most serious side effect
that would need to be assessed for with
a pt starting selective serotonin
reuptake inhibitor (SSRI) therapy?
Nausea &Vomiting
Increased suicidal ideations/attempts
Sleep pattern disturbance
Food/Drug interaction
Pharm Review-LDavis-2007
Question 12

Levothyroxine (Synthroid) is prescribed for a patient.
The RN teaches the pt to check their HR and notify the
MD/NP if their pulse is > 100 bpm because:
1.
Tachycardia may be an allergic reaction caused
by this medication
Excessive levels of the drug result in
tachycardia
Prolonged cardiac workload can occur as a
result of increased weight gain
Congestive heart failure can occur related to the
fluid and electrolyte shifts caused by the med
2.
3.
4.
Pharm Review-LDavis-2007
Question 13
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1.
2.
3.
4.
Acetaminophen (Tylenol) should be
used with caution in which clients?
Older adults with arthritis and dementia
Children with chicken pox and a fever
Pregnant women and teenagers with
anemia
Clients with chronic alcoholism and
hepatic disease
Pharm Review-LDavis-2007
Question 14
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1.
2.
3.
4.
5.
What medication is the antidote to
acetaminophen toxicity?
Furosemide (Lasix)
Acetylcysteine (Mucomyst)
Heparin
Activated charchoal
There is no antidote
Pharm Review-LDavis-2007
Question 15
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1.
2.
3.
4.
Pilocarpine (Pilocar) ocular therapy is
prescribed for a client. The nurse
would expect this client to have which
medical condition?
Glaucoma
Amblyopia
Astigmatism
Cataracts
Pharm Review-LDavis-2007
Question 16
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1.
2.
3.
4.
An RN is providing education to a
patient/family about proper use of a PCA
Pump. What statement would indicate
patient/family understanding?
Family member stating that they will hit the
button when they think the patient needs it
Pt states that they will wait until the pain is
very bad to use the pump
Pt states that they will use the pump to keep
their pain at comfortable level
Pt states that they will wait till the nurse is in
the room to use the PCA
Pharm Review-LDavis-2007
Question 17
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1.
2.
3.
4.
Antacids containing magnesium may
increase the risk of adverse physical
effects in clients with which condition:
Viral infection
Cardiac disease
Diabetes mellitus
Renal failure
Pharm Review-LDavis-2007
Question 18
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1.
2.
3.
4.
Which category of meds used to treat
asthma work by promoting smooth
muscle relaxation while dilating the
constricted bronchi and bronchioles?
Beta-adrenergic agents
Antihistamines
Corticosteroids
Anticholinergics
Pharm Review-LDavis-2007
Question 19

1.
2.
3.
4.
A client who is taking a benzodiazepine
for anxiety asks what kinds of
medications he might need to avoid.
The nurse would respond:
Cephalosporin antibiotics
Nonsteroidal anti-inflammatory drugs
Calcium channel blockers
Barbituates
Pharm Review-LDavis-2007
Question 20
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1.
2.
3.
4.
A client is receiving morphine sulfate IV
for post-op pain. Which assessment
finding would warrant immediate
attention?
Blood Pressure 150/90
Pulse Rate = 110
Pupillary constriction
Respiratory rate = 9
Pharm Review-LDavis-2007
Some Helpful Things You Might Want
to Know…..
Pharm Review-LDavis-2007
Insulin
Type
Lispro (Humalog)
Aspart (Novolog)
Regular
(Humulin R,
Novolin R,
Onset
15
minutes
30-60
minutes
Peak
30-90
minutes
4-6 hours
Duration
6-8 hours
6-8 hours
Regular Iletin)
IntermediateActing
NPH (Humulin N,
Novlin N)
lente (Humulin L,
Novolin L)
1 - 1.5 hrs 4-12 hours 24 hours
Ultralente
Lantus
Ultralente: 4-8
hours
1 - 2.5 hrs 7-15 hours 24 hours
10-30 hours
no pronounced
Lantus: 1-2Pharm
hours
peak
Review-LDavis-2007
36 hours
24+ hours
Helpful Websites

www.eriworld.com

www.cdc.gov

www.rxlist.com


This has the top 200 drugs for 2002.
www.rx.com
Pharm Review-LDavis-2007
THANK YOU FOR COMING
AND GOOD LUCK!!!!
Review material from ATI
testing, Kaplan Review, and
Eileen Horn RN MSN
Pharmacology Review.
Compiled by Lindsey Austin
Pharm Review-LDavis-2007