Deck 8: Drug Interactions and Over-The-Counter Drugs

Question 1

A client smokes regularly. She takes theophylline (Theo-Dur and others) daily. What is an effect of smoking while on theophylline?

A) Decrease in theophylline clearance
B) Increase in theophylline clearance
C) Increase in the distribution of theophylline
D) Decrease in the dose for theophylline

Answer 1

Increase in theophylline clearance

Question 2

The nurse is aware that drugs can block, decrease, or increase the actions of another drug. Laxatives can have which effect on drug absorption?

A) Increase
B) Decrease
C) Block
D) Enhance

Answer 2

Decrease

Question 3

A client receives morphine sulfate and demonstrates signs of respiratory depression. The physician orders naloxone (Narcan) to block the effects of the narcotic. When two drugs given concurrently have opposite effects, what kind of pharmacodynamic interactions occur?

A) Additive
B) Synergistic
C) Agonistic
D) Antagonistic

Answer 3

Antagonistic

Question 4

The nurse instructs a client with which condition to avoid taking over-the-counter cough and cold remedies?

A) High blood cholesterol
B) Rheumatoid arthritis
C) Hypotension
D) Thyroid disease

Question 5

A client is taking tetracycline for acne. It is a drug known to cause photosensitivity. To avoid phototoxicity, the nurse provides client teaching. Which statement by the client indicates a need for more teaching?

A) "I need to avoid excessive sunlight."
B) "I need to use sunscreen when I go out during the day."
C) "I need to wear protective clothing over exposed skin areas in sunlight."
D) "I can stay in the sun for only about 4 hours a day."

Question 6

A nurse is monitoring for drug interactions based on which premise about drug interactions?

A) Drug interactions are undesirable drug effects.
B) Drug interactions are changes occurring with drug absorption.
C) Drug interactions are altered effects of a drug from interaction with other drugs.
D) Drug interactions are reactions that occur in vitro.

Question 7

The nurse is caring for a client who is being treated with aspirin and an oral antidiabetic agent. The nurse anticipates an increased risk of _____ from the interaction between the drugs.

A) bleeding
B) clotting
C) hypoglycemia
D) hyperglycemia

Question 8

Cimetidine (Tagamet) is an enzyme inhibitor for the medication theophylline. Drugs that are enzyme inhibitors:

A) convert drugs to metabolites.
B) increase metabolism, promoting drug elimination.
C) decrease metabolism, promoting an increase in plasma drug concentration.
D) increase drug action.

Question 9

Some medications previously requiring a prescription are now available as over-the-counter (OTC) drugs. Client teaching related to OTC drugs should include:

A) instructions to take only prescribed drugs.
B) instructions to report OTC drugs being taken to the healthcare provider.
C) teaching that herbal drugs can be taken with prescribed drugs.
D) teaching that all OTC drugs are considered safe.

Question 10

A client is scheduled for surgery, and an antihistamine and narcotic have been prescribed as preoperative drugs. The antihistamine increases the effect of the narcotic. This is an example of which drug effect?

A) Additive
B) Potentiation
C) Opposing
D) Antagonistic

Question 11

The nurse has provided instructions to a client taking diazepam (Valium) for short-term anxiety. Which statement by the client indicates that the client needs additional instruction?

A) "I will avoid drinking alcohol while taking this drug."
B) "I will continue to eat grapefruit while taking this drug."
C) "I will avoid using heavy equipment when taking this drug."
D) "I will contact the healthcare provider if I develop a rash."

Question 12

Narcotics and anticholinergic drugs (atropine-like drugs) decrease gastrointestinal (GI) motility. Decreasing GI motility has what effect on drug absorption?

A) Increases drug absorption
B) Decreases drug absorption
C) Blocks drug absorption
D) Does not change drug absorption

Question 13

A client is ordered to receive warfarin (Coumadin), which is highly protein bound. Another medication that is equally highly protein bound is ordered. The nurse anticipates that the dosage will be:

A) increased for one drug.
B) increased for both drugs.
C) decreased for one drug.
D) decreased for both drugs.

Question 14

A client is taking antacids with an antibiotic. The nurse's instructions are based on the fact that antacids such as aluminum hydroxide (Amphojel) can:

A) increase drug absorption.
B) slow drug metabolism.
C) increase drug metabolism.
D) slow or block drug absorption.

Question 15

A client with a history of deep vein thrombosis takes warfarin (Coumadin) daily. He has been experiencing headaches and has been taking over-the-counter pain relievers. The nurse discovers that the client is taking aspirin. Which assessment should the nurse be most attentive to at this time?

A) The client reports that his gums are bleeding more than usual when he brushes his teeth.
B) The client complains of constipation.
C) The client reports that he is unable to sleep at night despite feeling very fatigued.
D) The nurse notes that the client has a runny nose and some nasal congestion.

Question 16

Food is known to increase, decrease, or delay drug absorption. A client has a high serum cholesterol level, and lovastatin (Mevacor) is prescribed. The client is taking the drug at mealtime and asks why this is necessary. What does taking lovastatin with food accomplish?

A) Decrease in drug absorption
B) Decrease in drug Absorption
C) Decrease in drug action
D) Increase in drug excretion

Question 17

A client is receiving two analgesics for pain relief. Two drugs with similar action are administered to achieve which kind of effect?

A) Additive
B) Synergistic
C) Opposing
D) Antagonistic

Question 18

The nurse is caring for a client who is being treated with both isoniazid and phenytoin. The nurse anticipates which result from the interaction between the drugs?

A) Toxic level of phenytoin
B) Subnormal level of isoniazid
C) Toxic level of isoniazid
D) Subnormal level of phenytoin

Question 19

Some drugs can affect the excretion of other drugs. The antidysrhythmic drug quinidine decreases the excretion of digoxin (Lanoxin). How would the digoxin concentration in the body fluids be affected?

A) No effect
B) Decreased
C) Increased
D) Unabsorbed

Question 20

A client eats a large meal and then takes her medications. Usually food has which effect on drug dissolution and absorption?

A) Enhances
B) Increases
C) Decreases
D) No effect

Question 21

Which drug groups are considered to be over-the-counter (OTC) drug groups? (Select all that apply.)

A) Herbal products
B) Laxatives
C) Antibiotics
D) Antacids

Question 22

The nurse notes that the client has been ordered to receive both aminophylline and dobutamine by IV infusion. The client has one IV access and has been dehydrated. What is the highest priority action on the part of the nurse?

A) Call the pharmacist for additional information on the medications.
B) Start a second intravenous access in the client's arm.
C) Call the physician for orders regarding the medications.
D) Administer the medications using piggyback tubing.