Advanced Pharmacology Test Bank

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The nurse administers IV push hydralazine (Apresoline) to a client with severe hypertension. Which assessment finding requires immediate action?

  • A. Blood pressure of 140/90 mmHg
  • B. Heart rate of 110 beats per minute
  • C. Headache
  • D. Flushing
Correct Answer: B

Rationale: Hydralazine, a vasodilator, lowers blood pressure but triggers reflex tachycardia. A heart rate of 110 bpm indicates significant compensation, risking ischemia or strain, requiring immediate action (e.g., slowing infusion, notifying physician). BP of 140/90 is improved, not critical. Headache and flushing are expected from vasodilation, less urgent. Tachycardia's potential to destabilize circulation, especially in severe hypertension, aligns with hydralazine's pharmacology'arteriolar relaxation prompts sympathetic response. This finding demands swift intervention to prevent cardiovascular collapse, making B the priority over manageable side effects.

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A patient asks how to apply transdermal nitroglycerin. What is the nurse™s best response?

  • A. Always apply the transdermal patch over the area of your chest where your heart is.
  • B. Keep the previous patch on for 1 full day so you always have two patches on at a tim
  • C. 
  • D. Apply the patch to hairless areas of the body.
Correct Answer: D

Rationale: Transdermal nitroglycerin patches should be applied to clean, dry, hairless areas of the body to ensure proper absorption of the medication. Hair can interfere with the absorption of the medication through the skin. Commonly recommended areas for application include the chest, upper arm, or abdomen. It is important to rotate application sites to prevent skin irritation and to follow the specific instructions provided by the healthcare provider or pharmacist.

The specificity of the adrenergic blocking agents allows the clinician to select a drug to do what?

  • A. Have the desired effect
  • B. Multiply undesired effects
  • C. Increase specificity with higher serum blood levels
  • D. Improving concentration in the body
Correct Answer: A

Rationale: This specificity allows the clinician to select a drug that will have the desired therapeutic effects without the undesired effects that occur when the entire sympathetic nervous system is blocked. In general, however, the specificity of adrenergic blocking agents depends on the concentration of drug in the body. Most specificity is lost with higher serum drug levels. The nurse should understand the importance of drug specificity to ensure safe and effective administration.

The nurse administering the phosphodiesterase inhibitor milrinone (Primacor) recognizes that this drug will have a positive inotropic effect. Which result reflects this effect?

  • A. Increased heart rate
  • B. Increased blood vessel dilation
  • C. Increased force of cardiac contractions
  • D. Increased conduction of electrical impulses across the heart
Correct Answer: C

Rationale: Milrinone is a phosphodiesterase inhibitor that works by increasing the levels of cyclic adenosine monophosphate (cAMP) within cardiac myocytes. This leads to enhanced calcium influx into the cells, ultimately resulting in increased force of cardiac contractions (positive inotropic effect). This increased contractility helps improve cardiac output without necessarily increasing heart rate or affecting blood vessel dilation.

The nurse manages care for several clients receiving hormone replacement therapy (HRT). What will the priority assessment by the nurse include as related to side effects?

  • A. Pain in the calf
  • B. Decreased libido
  • C. Low-back pain
  • D. Chronic fatigue
Correct Answer: A

Rationale: HRT increases clotting risk, making calf pain a priority due to potential DVT, a life-threatening side effect. Libido , back pain , and fatigue are less urgent. A ensures safety, aligning with HRT risks, making it the priority.

A client has just been prescribed with methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to?

  • A. Clay-colored stool is a normal response to the treatment.
  • B. Pregnancy is not contraindicated with the use of the medication.
  • C. Strict hand washing.
  • D. Get a daily source of sunlight during the day.
Correct Answer: C

Rationale: Methotrexate is an immunosuppressant, increasing the risk of infections. Strict hand washing and infection prevention measures are crucial. Clay-colored stools are not normal and may indicate liver dysfunction. Pregnancy is contraindicated due to the risk of fetal harm. Sunlight exposure should be limited to reduce the risk of photosensitivity reactions.

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