Deck 107: Miscellaneous Noteworthy Drugs

Question 1

A nurse counsels a patient who is to begin taking gamma-hydroxybutyrate (Xyrem) for narcolepsy. It is important for the nurse to warn the patient that respiratory depression is a potential risk with concomitant use of:

A) alcohol.
B) beta blockers.
C) caffeine.
D) nicotine.

Answer 1

alcohol.

Question 2

A patient with a history of heart disease develops pulmonary arterial hypertension (PAH), and the provider is considering prescribing sildenafil (Revatio). The nurse caring for this patient will perform a careful drug history and notify the provider if the patient is taking which medication?

A) A beta blocker
B) A calcium channel blocker
C) Nitroglycerin
D) Warfarin

Answer 2

Nitroglycerin

Question 3

An adult patient with sickle cell anemia is being treated for a severe acute crisis with an opioid analgesic, a glucocorticoid, and hydroxyurea. The patient's complete blood count reveals neutrophils 2,000/mm³, platelets 85,000/ mm³, reticulocytes 85,000/ mm³, and a hemoglobin of 4.2 gm/dL. What will the nurse anticipate doing?

A) Decreasing the glucocorticoid dose
B) Increasing the glucocorticoid dose
C) Increasing the hydroxyurea dose
D) Stopping the hydroxyurea

Answer 3

Stopping the hydroxyurea

Question 4

A nurse is quizzing a nursing student who is preparing to care for a patient with cystic fibrosis. The patient uses inhaled tobramycin (TOBI), dornase alfa (Pulmozyme), ibuprofen, and salmeterol (Serevent Diskus). Which statement by the student indicates understanding of this patient's drug regimen?

A) "Dornase alfa is used as needed to decrease viscosity of sputum."
B) "Ibuprofen is used to minimize pleuritic pain associated with coughing."
C) "Salmeterol acts by causing bronchodilation and improving ciliary function."
D) "Tobramycin is given via a metered-dose inhaler to avoid systemic side effects."

Question 5

A patient with cancer is taking rasburicase (Elitek) to treat hyperuricemia and develops neutropenia with fever and respiratory distress on the fourth day of treatment. The nurse caring for this patient will expect to:

A) administer allopurinol instead of rasburicase.
B) continue giving the drug and monitor the patient's symptoms closely.
C) tell the patient that this drug should never be used again.
D) tell the patient that these symptoms indicate severe sepsis.

Question 6

The nurse provides teaching for a patient who will begin taking bosentan (Tracleer) for pulmonary arterial hypertension (PAH). Which statement by the patient indicates a need for further teaching about this medication?

A) "I may take this medication with or without food."
B) "I may develop irreversible liver damage while taking this drug."
C) "I should not take cyclosporine while taking this medication."
D) "I will need to have lab tests every month while taking this drug."

Question 7

A previously healthy patient develops sepsis. The patient's lab tests reveal deterioration of renal and hepatic function, and the provider orders drotrecogin alfa (Xigris) to be given intravenously at a rate of 1,440 mcg per hour for 96 hours. The patient, who weighs 60 kg, has a history of myocardial infarction and takes 81 mg of aspirin daily. What will the nurse do?

A) Administer the medication and monitor vital signs, level of consciousness, and abdominal discomfort.
B) Contact the provider and request discontinuation of the order since drotrecogin alfa is contraindicated with aspirin.
C) Notify the provider that the patient takes aspirin and ask that the medication dose be decreased to 720 mcg per hour.
D) Prepare to administer infusions of platelets while giving the drotrecogin alfa.

Question 8

A patient with cystic fibrosis uses inhaled tobramycin (TOBI) 300 mg every 12 hours in repeating cycles of 4 weeks on and 4 weeks off. The patient reports hoarseness and tinnitus. The nurse will tell the patient that:

A) an intravenous form may be used to avoid hoarseness.
B) hearing loss may occur with continued use of the drug.
C) the provider will need to monitor renal function closely.
D) these are common side effects of this medication.

Question 9

A pregnant patient begins active labor at 30 weeks' gestation. The provider orders dexamethasone 6 mg intramuscularly to be given twice daily for 4 doses. The patient asks the nurse what effect this drug will have on the fetus. The nurse will tell her that the dexamethasone is given to:

A) improve cognitive function in the fetus.
B) improve fetal neuromotor development.
C) increase fetal weight and length.
D) increase lung development in the fetus.

Question 10

A patient who has pulmonary arterial hypertension (PAH) is receiving epoprostenol (Flolan) at a rate of 210 ng per minute using a portable pump. The patient weighs 70 kg. The patient calls the clinic to report headache, nausea, and vomiting. The nurse will counsel the patient to:

A) decrease the infusion to 100 ng per minute.
B) discuss these side effects with the provider.
C) prepare for a hospital admission.
D) stop the infusion and contact the provider.