Question 1

The nurse is preparing to administer meperidine (Demerol),which is an opioid analgesic,and promethazine (Phenergan),which is an antiemetic and antihistamine.The nurse understands that these drugs are given in combination for which reason?

Accepted Answer

Meperidine and promethazine have a synergistic effect on each other with a clinical effect that is substantially greater than the combined effect of the two.

Question 2

The nurse is caring for a patient who receives theophylline,which has a narrow therapeutic index.The patient has been receiving cimetidine but will stop taking that drug in 2 days.In 2 days,the nurse will observe the patient closely for

Accepted Answer

Cimetidine is an enzyme inhibitor that decreases the metabolism of drugs such as theophylline.If the cimetidine is discontinued,the theophylline dose should be decreased to avoid toxicity.The nurse should observe the patient for increased theophylline effects.

Question 3

A patient has been taking a drug for several years and tells the nurse it is no longer working.The nurse learns that the patient has recently begun taking an over-the-counter antacid medication.What does the nurse suspect is occurring?

Accepted Answer

Drug interactions are an altered or modified action or effect of a drug as a result of interaction with one or more other drugs.An adverse drug reaction can occur with one or more drugs and has effects ranging from mild to severe toxicity.Drug incompatibility is a chemical reaction of two or more drugs that occurs in vitro.Drug tolerance is the development of reduced response to a medication over time.

Question 4

The nurse is educating the parent of a 20-month-old toddler about over-the-counter (OTC)products to treat cold symptoms.Which statement by the parent indicates understanding of the teaching?

Accepted Answer

OTC cold medications can mask symptoms and prevent accurate diagnosis of potentially serious illnesses.Their use in children is not recommended.

Question 5

Which patients are at high risk for drug interactions? (Select all that apply. )

Accepted Answer

Patients who have chronic health conditions,take multiple medications,see more than one provider,and use supplements and OTC medications are at higher risk for drug interactions.

Question 6

A patient will receive penicillin to treat an infection.The provider orders probenecid (Probalan),a medication to treat gout,even though the patient does not have gout.Which action by the nurse is correct?

Accepted Answer

Two or more drugs with the same route of excretion may compete with each other for elimination.Probenecid is given because it inhibits the excretion of penicillin,which may be desirable when the provider wants to prolong the plasma concentration of penicillin.The nurse should always verify an order that may not be clear.

Question 7

A patient who takes the anticoagulant warfarin will begin taking the anticonvulsant drug carbamazepine.The nurse reviews the drug information for these drugs and learns that carbamazepine is a hepatic enzyme inducer.The nurse anticipates that the provider will make which dosage adjustment?

Accepted Answer

Carbamazepine is a hepatic enzyme inducer,which can increase drug metabolism.Patients taking both drugs usually need a larger dose of warfarin.

Question 8

The nurse is teaching a patient about a drug that causes photosensitivity.Which statement by the patient indicates a need for further teaching?

Accepted Answer

Drugs that cause photosensitivity make sunburn more likely,so patients should stay out of the sun,wear protective clothing,and use sunscreen with an SPF greater than 15.It is not necessary to wear sunglasses indoors.

Question 9

The nurse is caring for a patient who takes digoxin to treat heart failure.The provider orders furosemide to treat edema.The nurse will monitor the patient for digitalis toxicity because of

Accepted Answer

Diuretics such as furosemide promote water and sodium excretion from the renal tubules,especially sodium and potassium.Hypokalemia can result,and this will enhance the action of digoxin,and digitalis toxicity can occur.

Question 10

The nurse assesses a patient who is receiving morphine sulfate intravenously using a patient-controlled analgesia pump.The nurse notes somnolence and respiratory depression,which are signs of morphine toxicity.The nurse will prepare to administer naloxone (Narcan)because it

Accepted Answer

Naloxone is a narcotic antagonist,meaning that it reverses the effects of morphine by blocking morphine receptor sites.

Question 11

The provider has ordered amoxicillin with clavulanate (Augmentin)for a child who has otitis media.The child's parent asks why this drug is necessary when amoxicillin is less expensive.The nurse will explain that clavulanate is added to amoxicillin because it

Accepted Answer

Clavulanate is a bacterial enzyme inhibitor,specifically beta-lactamase,which inactivates amoxicillin.When added to amoxicillin,it broadens the antibacterial spectrum.

Question 12

The nurse is preparing to administer two intravenous medications that should not be given using the same IV tubing.The nurse understands that this is because of drug

Accepted Answer

Drugs that are incompatible cannot be mixed together in solution and cannot be mixed in a syringe,IV bag,or other artificial environment.Adverse reactions are symptoms occurring from drug effects.Drug interactions occur in vivo.Potentiation is when one drug causes an enhanced response in another drug.

Question 13

The nurse is teaching a patient who will begin taking ciprofloxacin.What instruction will the nurse include when teaching this patient about this drug?

Accepted Answer

Dairy products,multivitamins,and antacids should be avoided 1 hour before and 2 hours after taking ciprofloxacin because these products contain divalent cations that form a drug complex that prevents absorption of the ciprofloxacin.

Question 14

A patient asks the nurse about using over-the-counter (OTC)medications.The nurse will tell the patient that OTC medications

Accepted Answer

OTC medications should always be included when listing medications because they can cause drug interactions.OTC medications can be as effective and as safe as prescription medications and have as many side effects and adverse reactions.

Question 15

A young adult female patient who takes a combination oral contraceptive (OCP)will begin taking an antibiotic.When teaching the patient about this medication,the nurse will

Accepted Answer

Gut bacteria are necessary to hydrolyze estrogen conjugates into free estrogens.Concurrent antibiotic administration can alter these bacteria and prevent the optimal absorption and effectiveness of OCPs.A backup contraceptive method is recommended.

Question 16

A patient is taking phenytoin to prevent seizures.The nurse knows that phenytoin is highly protein-bound and has sedative side effects.The nurse reviews the patient's chart and notes a low serum albumin.The nurse will notify the provider and observe the patient for which effects?

Accepted Answer

Phenytoin is protein-bound.When patients have a low serum albumin,there are fewer protein-binding sites,leaving more free drug in the system.The nurse should expect an increase in sedative side effects.

Question 17

A patient has been taking warfarin (Coumadin),which is highly protein-bound.The patient will begin taking gemfibrozil,which is also highly protein-bound.The nurse will observe the patient closely for

Accepted Answer

The addition of a highly protein-bound drug will compete with warfarin for protein- binding sites,releasing more free warfarin into the system,increasing drug effects and increasing the chance of toxicity.

Question 18

A patient who takes a drug that undergoes gastric absorption will begin taking an opioid analgesic after sustaining an injury in a motor vehicle accident.The nurse will observe the patient closely for which effects?

Accepted Answer

Opioids slow gastric emptying,allowing more time for drugs absorbed in the stomach to be absorbed.The nurse should expect increased effects of the first drug.

Question 19

The nurse is preparing to administer erythromycin to a patient who takes digoxin.The nurse will plan to monitor the patient for

Accepted Answer

Intestinal flora have the ability to metabolize digoxin,and any drug that destroys or inhibits growth of these gastrointestinal microflora can increase digoxin levels leading to toxicity.

Question 20

A patient who takes warfarin (Coumadin)asks the nurse about taking a medication for headaches.The nurse will recommend which medication?

Accepted Answer

Aspirin and NSAIDs can increase the risk of hemorrhage in patients taking anticoagulants.Acetaminophen is safe and may be recommended.

Quiz 4: Drug Interactions and Over-The-Counter Drugs

The nurse is preparing to administer meperidine (Demerol) ,which is an opioid analgesic,and promethazine (Phenergan) ,which is an antiemetic and antihistamine.The nurse understands that these drugs are given in combination for which reason?

The nurse is caring for a patient who receives theophylline,which has a narrow therapeutic index.The patient has been receiving cimetidine but will stop taking that drug in 2 days.In 2 days,the nurse will observe the patient closely for

A patient has been taking a drug for several years and tells the nurse it is no longer working.The nurse learns that the patient has recently begun taking an over-the-counter antacid medication.What does the nurse suspect is occurring?

The nurse is educating the parent of a 20-month-old toddler about over-the-counter (OTC) products to treat cold symptoms.Which statement by the parent indicates understanding of the teaching?

Which patients are at high risk for drug interactions? (Select all that apply. )

A patient will receive penicillin to treat an infection.The provider orders probenecid (Probalan) ,a medication to treat gout,even though the patient does not have gout.Which action by the nurse is correct?

A patient who takes the anticoagulant warfarin will begin taking the anticonvulsant drug carbamazepine.The nurse reviews the drug information for these drugs and learns that carbamazepine is a hepatic enzyme inducer.The nurse anticipates that the provider will make which dosage adjustment?

The nurse is teaching a patient about a drug that causes photosensitivity.Which statement by the patient indicates a need for further teaching?

The nurse is caring for a patient who takes digoxin to treat heart failure.The provider orders furosemide to treat edema.The nurse will monitor the patient for digitalis toxicity because of

The nurse assesses a patient who is receiving morphine sulfate intravenously using a patient-controlled analgesia pump.The nurse notes somnolence and respiratory depression,which are signs of morphine toxicity.The nurse will prepare to administer naloxone (Narcan) because it

The provider has ordered amoxicillin with clavulanate (Augmentin) for a child who has otitis media.The child's parent asks why this drug is necessary when amoxicillin is less expensive.The nurse will explain that clavulanate is added to amoxicillin because it

The nurse is preparing to administer two intravenous medications that should not be given using the same IV tubing.The nurse understands that this is because of drug

The nurse is teaching a patient who will begin taking ciprofloxacin.What instruction will the nurse include when teaching this patient about this drug?

A patient asks the nurse about using over-the-counter (OTC) medications.The nurse will tell the patient that OTC medications

A young adult female patient who takes a combination oral contraceptive (OCP) will begin taking an antibiotic.When teaching the patient about this medication,the nurse will

A patient is taking phenytoin to prevent seizures.The nurse knows that phenytoin is highly protein-bound and has sedative side effects.The nurse reviews the patient's chart and notes a low serum albumin.The nurse will notify the provider and observe the patient for which effects?

A patient has been taking warfarin (Coumadin) ,which is highly protein-bound.The patient will begin taking gemfibrozil,which is also highly protein-bound.The nurse will observe the patient closely for

A patient who takes a drug that undergoes gastric absorption will begin taking an opioid analgesic after sustaining an injury in a motor vehicle accident.The nurse will observe the patient closely for which effects?

The nurse is preparing to administer erythromycin to a patient who takes digoxin.The nurse will plan to monitor the patient for

A patient who takes warfarin (Coumadin) asks the nurse about taking a medication for headaches.The nurse will recommend which medication?