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PHARMA

Email *

[Link]@[Link]

SURNAME:: * ···/1

SALAZAR

FIRST NAME: * ···/1

GWYNTHSELLE

MIDDLE NAME: * ···/1

N/A

SCHOOL * ···/1

SOUTHWESTERN UNIVERSITY PHINMA

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LEVEL * ···/1

Option 3

SITUATION: Mr. Hero Fernando, a 60 year-old bank manager had *1/1

experienced a sensation of chest tightness, chest pain, sweating and a
feeling of apprehension. A diagnosis of CAD with angina pectoris was
established

1. The physician orders for nitroglycerin tablet. The nurse knows that
the pharmacological action of the drug is:

a. To dissolve the atheromatous plaque in the coronary artery

b. Constrict the venous vessels and capillaries

c. Dilate the coronary arteries

d. Decrease the myocardial consumption of oxygen

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2. The nurse gave instructions to the patient on nitroglycerin intake. He *1/1

remarked, “I think I will try not to take too many of these pills.” At this
instance, the nurse’s BEST reply would be:

a. “I agree, nitroglycerin can cause drug addiction, that is why you must not take too
many of the pills”

b. “I must inform you that nitroglycerin is non-habituating and you should take the
pills many times to relieve the pain”

c. “You will be needing only three tablets to ease the pain and if unrelieved, you
must seek medical attention”

d. “ There is no problem with continuous daily intake because nitroglycerin does not
cause a tolerance effect”

3. The nurse must emphasize to the patient which ONE of the following *1/1
side-effects of nitroglycerin:

a. Headache

b. Hypertension

c. . Nausea and vomiting

d. Visual changes

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4. What other information must the nurse provide to the patient taking the *1/1
nitroglycerin?

a. Keep the tablet in a clear container

b. Take the tablet with meals

c. Continue to take as many tablets of nitroglycerin until chest pain subsides

d. A burning sensation under the tongue is expected

5. The nurse applies the ordered nitroglycerin ointment on the patient’s *1/1
chest wall. Which nursing action is considered inappropriate?

a. The nurse chooses a hairless area

b. She spreads the ointment with her fingers

c. She removes the ointment on the skin from the previous dose

d. She rotates the sites of ointment application

6. The nurse gives which of the following discharge instructions to this *0/1
patient with angina regarding nitroglycerin therapy?

a. Only take the nitroglycerin as desired

b. The drug should be taken before engaging in exertional activities

c. The tablet should be taken only in the morning

d. If the drug does not relieve the pain, increase the frequency of the dose

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7. Hero asked the nurse what he could do about his concern about sex *0/1
activity. The nurse best suggests:

a. Tell him to avoid sex for several months while his heart is on therapy

b. Suggests that his wife assume the top position

c. Tell him to avoid sex on days when he is anxious

d. Advise that he should have sex only once a month

8. The nurse understands that her discharge teaching is effective *1/1

regarding life style modification when the patient says:

a. “I know that I will need to eat less, so I will eat once a day only”

b. “I will stay on bed most of the time so I wont experience chest pain”

c. “I will stop what I’m doing whenever I have pain and take the pill”

d. “I need to enroll in a gym class to have a vigorous exercise to condition my heart”

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SITUATION: Manny is admitted to the medical ward with the diagnosis *1/1
of essential hypertension. He had hypertensive emergency 2 hours ago
and was hospitalized for further observation.
The nurse administers prescribed anti-hypertensive meds. If it can be any
of the following, she will check the pulse prior to giving:

a. Nifedipine

b. Metoprolol

c. Clonidine

d. Captopril

10. After administering a blood-pressure lowing agent, the nurse must *1/1
caution the patient:

a. To avoid straining during defecation

b. To avoid low-sodium and potassium diet

c. To avoid abrupt change of positions

d. To take warm shower immediately after taking the drug

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11. The nurse prepares to give a diet appropriate for a hypertensive *1/1
patient. Which food should the nurse include in the menu?

a. Canned meat loaf

b. Scallops and shrimps

c. Fresh citrus juice and cake

d. Butter and pork steaks

12. If the physician orders Captopril as the home medication for the high *1/1
BP, the nurse must caution that the side-effect of this drug that is
disturbing is:

a. Rashes

b. Cough

c. Pruritus

d. Ringing of the ears

13. If the client is discharged with home medication of Propranolol *0/1

hydrochloride, the nurse must include in her medication-teaching plan
which one?

a. Take the medication on an empty stomach

b. Obtain blood pressure readings regularly

c. Perform active exercises to prevent Hypotension

d. Caution to avoid hazardous activities after taking the drug

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14. The nurse determines that the following drugs are calcium channel *1/1
blockers that can be prescribed by the physician to the patient. One is not
included:

a. Nifedipine

b. Verapamil

c. Telmisartan

d. Diltiazem

SITUATION: Joseph,, 50 y.o. Businessman awakens in the middle of the *1/1

night with dyspnea, bilateral basilar rales and frothy sputum. He is
brought to the Mulawin hospital. His diagnosis is congestive heart
failure.
15. The physician gives the patient furosemide and digoxin. The nurse’s
main concern is to:

a. Take the central venous pressure reading

b. Observe for decrease edema

c. Observe for signs and symptoms of hypokalemia

d. Force fluids

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16. The mechanism of action of dioxin that makes it useful in patients *1/1
with CHF is that it:

a. Produces a negative inotropic effect

b. Increases cardiac conduction

c. Enhances cardiac contractility

d. Increases the heart rate

17. The nurse is very vigilant about digoxin overdose. Which one *0/1
statement below by the patient may alert the nurse of a possible
development of toxicity?

a. “Nurse, I don’t feel like eating for the past few days”

b. “I am having constipation lately”

c. “I am developing a nagging cough and night terrors”

d. “I am experiencing dryness of the eyes and sandy sensation”

18. The nurse evaluates that the drug digoxin is effective when the *1/1
patient manifests:

a. Decreased bowel sounds

b. Increased urine output

c. Increased drowsiness

d. Decreased sympathetic response of the body

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19. The following manifestations must be assessed by the nurse to *0/1

detect beginning digitalis toxicity, with the exception of:

a. Nausea and vomiting

b. Palpitations

c. Diplopia and visual yellow-green halos

d. Hypertension

20. The nurse instructs the patient on diet modification during digitalis *0/1
therapy. She is certain that her teaching is effective when the patient will
choose all the foods items below, except:

a. Fresh orange juice and potato fries

b. Dried mangoes and tomato juice

c. Broccoli salad with bean sprouts

d. Flavored gelatin and iced tea

21. The nurse obtains an apical pulse of 78 beats/min. She is bringing the *0/1
next dose of digoxin and then proceeds to do which one action below?

a. Withhold the drug and notify the physician

b. Start IV infusion of Digibind (digoxin antibody)

c. Instruct patient to consume more meat and nuts

d. Administer the drug

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SITUATION: Armida, an 18-year-old adolescent is seen in the health *1/1

center because of easy fatigability and frequent dizziness
22. The health center physician determines that she has iron-deficiency
anemia. The nurse will anticipate the doctor to order for:

a. Bone marrow aspiration

b. Hemoglobin level determination

c. Platelet count

d. BUN and Creatinine

23. A drug is administered to correct anemia, such as an iron. This drug *0/1
is classified as:

a. Antihelminthic

b. Anticoagulant

c. Hematinic

d. Antihistaminic

24. The nurse administers the oral iron tablet. She will give the *1/1
medication:

a. With milk and dairy products

b. With antacids to minimize gastric upset

c. With fruit juices like calamansi and orange

d. With a full glass of coffee or tea

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25. The nurse instructs the patient to eat iron-rich foods. She determines *1/1
that her teaching is effective when the client will choose:

a. Pomelo juice and hamburger

b. Gelatin and marshmallows

c. Lean meat and buttered corn

d. Liver and eggyolk

26. The doctor decides to order Iron dextran one ampoule. The nurse *0/1
prepares to administer the drug:

a. Intravenously. Slow IV push

b. Intamuscular, Z-track method

c. Subcutaneous

d. Intrathecal

27. The nurse must warn the patient taking oral iron preparations that it *1/1
can cause which side effect/s?

a. Absence of Vitamin E in the diet

b. Presence of excessive iron in the liver

c. Absence of intrinsic factor in the stomach

d. Temporary bone marrow depression.

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SITUATION: Mrs. Rosalinda Amor, 23 year-old actress is admitted *1/1

because of a diagnosis of deep vein thrombosis.
29. The nurse employs which of the following non-pharmacological
measures in caring for Mrs. Amor?

a. Ice compress over the involved leg TID

b. Elevate the legs with a pillow

c. Maintain on strict bed rest with minimal bathroom privileges

d. Massage the involved area

30. The physician orders Heparin sodium for Mrs. Amor. The nurse *1/1
understands the reason for this therapy is that:

a. Heparin will dissolve the clots in the inflamed veins to prevent emobolization

b. There is a need to prevent further clot formation in the involved vessels

c. Heparin will anticoauglate the blood by inhibiting vitamin K metabolism

d. The clot formed in the vein must be lysed by activating plasmin, the action of
heparin

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31. If the doctor orders for heparin therapy monitoring, the nurse must *1/1
obtain which laboratory tests from the lab unit?

a. Prothrombin time

b. Clotting time

c. Partial thromboplastin time

d. Prothrombin consumption test

32. The above laboratory value must is considered therapeutic if the *0/1
result is about:

a. 3 times the normal

b. 2 times the normal

c. Equals the normal

d. Less than the normal

33. The nurse must administer heparin to Mrs. Amor. She determines *0/1
that the most common routes of administration are:

a. IV and IM

b. SC and IV

c. ID and IM

d. IV and intrathecal

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34. When the nurse is monitoring the patient for heparin overdose, she is *0/1
observing for the following signs/symptoms, except?

a. Ecchymoses

b. Positive Homan’s sign

c. Dark, cola-colored urine

d. Epistaxis

35. Which one effect of heparin therapy will cause nursing concern? * 1/1

a. Thrombocytopenia

b. Constipation

c. Bone marrow depression

d. Dizziness

36. In the event of an overdose of heparin injection, the nurse prepares *1/1
which one antidote for toxicity?

a. Phytomenadione

b. Atropine Sulfate

c. Protamine sulfate

d. Deferoxamine chelators

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37. The doctor switched from standard heparin to low molecular weight *0/1
heparin injection. The advantage of LMWH over the standard heparin is:

a. The LMWH can be administered IM

b. The LMWH does not need frequent laboratory monitoring

c. The LMWH has a better potency

d. The LMWH does not cause bleeding problems

38. The nurse reads the chart and notes for an order of oral Warfarin *0/1
sodium, while the patient is on heparin therapy. The nurse will:

a. Question the order because of potential excessive bleeding if given

simultaneously

b. Administer the drug as ordered

c. Withhold the heparin and administer the Warfarin orally

d. Report the error to the nurse supervisor as the patient may be at risk for toxicity

39. IF Mrs. Amor is discharge with warfarin sodium, the nurse must *1/1
include in her discharge teaching which one?

a. Keep Vitamin A ampule available for injection c/o the health center in case of
emergency

b. Report any bright red blood in the stool or urine

c. Take aspirin to manage the headache side-effect of the drug

d. Utilize firm toothbrush when brushing to prevent build up of plaques and gingival
hyperplasia

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40. The nurse must remind the patient that warfarin therapy is monitored *1/1
with the use of which laboratory examinations?

a. PT and PTT

b. PT and INR

c. Clotting time and bleeding time

d. Platelet count and PT

SITUATION: Mrs. Avery had a previous attack of mild stroke and *0/1
coronary artery disease. She is taking Aspirin.
41. The reason aspirin is utilized as an anti-platelet medication is
because:

a. Aspirin can prolong the bleeding time

b. Aspirin affects the thromboxane production of the platelet

c. Aspirin interferes with the receptor binding of the platelets

d. Aspirin blocks the degranulation process inhibiting release of histamine

42. The nurse administers aspirin: * 1/1

a. On an empty stomach to increase absorption

b. With meals

c. In Between meals

d. Intramuscularly

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43. Mrs. Avery had a sudden severe and prolonged chest pain. Acute MI *0/1
is suspected. The nurse anticipates the doctor to order a fibrinolytic, and
this may be:

a. Tranexamic Acid

b. Dipyridamole

c. Streptokinase

d. Coumadin

44. If the above drug is ordered to be given IV drip, the nurse must be *1/1
aware of which potential effect?

a. Hypersensitivity reaction

b. Congestive heart failure

c. Further damage to the myocardium

d. Excessive clot formation

45. If the patient is receiving tissue-plasminogen activator, the nurse *0/1

must make which one priority intervention?

a. Have heparin sodium available

b. Monitor closely the renal status

c. Observe for psychotic symptoms

d. Obtain a stand by Aminocaproic acid

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SITUATION: A patient is determined to have hypercholesterolemia and is *0/1

admitted in the hospital for treatment of her condition. The doctor
ordered Lovastatin OD.
46. The nurse determines that the BEST time to give the drug is:

a. In the morning before breakfast to promote absorption

b. In the afternoon to promote sleep because it is sedating

c. At bedtime

d. In between meals

47. The nurse is knowledgeable about the mode of action of lovastatin *0/1
that it:

a. It Inhibits the formation of chylomicrons in the intestinal cells

b. It prevents the enzyme that synthesizes cholesterol

c. It binds with bile acids and cholesterol promoting excretion

d. It promotes cholesterol metabolism in the adipose tissue to lower the plasma

cholestero

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48. The nurse is prepared to provide comfort measure to the common *0/1
side effects of the drug. She monitors the patient for:

a. Abdominal fullness, flatulence and diarrhea

b. Confusion and psychoses

c. Palpitations and arrhythmias

d. Hypertension and rashes

49. The nurse must monitor for these serious adverse effects of *0/1
lovastatin. Which one is not included?

a. Glaucoma

b. Cataract

c. Myositis

d. Hepatic failure

50. The nurse reads the drug order sheet and is most concern to consult *0/1
the physician if he orders:

a. Paracetamol

b. Gemfibrozil

c. Vitamin supplements

d. Omeprazole

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