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The Pharmacology Review

The Pharmacology Review. Leslie Davis, MSN, RN, CS, ANP Clinical Associate Professor UNC CH, School of Nursing. Some Test Taking Tips For the NCLEX and Beyond. Know your normal lab values! These can have a Huge Impact on Meds you may give. Know Side Effects to Common Meds

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The Pharmacology Review

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  1. The Pharmacology Review Leslie Davis, MSN, RN, CS, ANP Clinical Associate Professor UNC CH, School of Nursing Pharm Review-LDavis-2007

  2. Some Test Taking Tips For the NCLEX and Beyond • Know your normal lab values! These can have a Huge Impact on Meds you may give. • Know Side Effects to Common Meds • Know Commonly Prescribed Meds and what their Therapeutic Use is. Pharm Review-LDavis-2007

  3. Most important lab values to know • K+ (3.5-5.0) • Hgb/ Hct • When to do PT/INR vs. PTT • Toxic values to know • Digoxin levels > 2.0 • Lithium levels > 2.0 • Dilantin levels > 20.0 Pharm Review-LDavis-2007

  4. Now for the Question & Answer Portion of the Afternoon……. Pharm Review-LDavis-2007

  5. Question 1: • If Regular Insulin is given at 0730am when is a reaction most likely?? • 11am • 2pm • 5pm • 9pm Pharm Review-LDavis-2007

  6. Question 2 • Which patient would you be most concerned with digitalis toxicity? • Patient with constipation • Patient with serum potassium of 4.1 • Patient taking HCTZ • Patient taking oral diabetic agents Pharm Review-LDavis-2007

  7. Question 3 • A patient recently admitted to the ICU is having frequent premature ventricular contractions that are symptomatic. Which of the following medications would you expect this patient to receive? • Digoxin • Furosemide • Lidocaine • Levophed Pharm Review-LDavis-2007

  8. Question 4 • Which lab value would you monitor closely with a patient receiving IV Heparin? • Protrombin time (PT) • Platelet Count • International normalized ratio (INR) • Partial thromboplastin time (PTT) Pharm Review-LDavis-2007

  9. Question 5 • Which Lab Value would you monitor closely with a patient receiving warfarin (Coumadin)? • White Blood Cell Count (WBC) • Platelet count • International normalized ratio (INR) • Partial thromboplastin time (PTT) Pharm Review-LDavis-2007

  10. Question 6 • The RN instructs the client taking warfarin (Coumadin) about interactions. Which drug could increase the risk of adverse effects for the client? • Furosemide (Lasix) • Diazepam (Valium) • Digoxin (Lanoxin) • Acetylsalicylic Acid (Aspirin) Pharm Review-LDavis-2007

  11. Question 7 • Your pt is receiving steroid taper of Prednisone. The pt asks why you can’t stop the medicine quickly. Your response is: • To avoid systemic toxicity • To facilitate natural adrenocortical function • To prevent glycosuria • To prevent fluid and electrolyte imbalance Pharm Review-LDavis-2007

  12. Question 8 • What is a concern associated with long term use of diazepam (Valium)? • Decreased ability to maintain balance • Muscle atrophy • Abrupt discontinuation of therapy • Orthostatic hypotension Pharm Review-LDavis-2007

  13. Question 9 • A pt being treated for bipolar disorder is receiving Lithium therapy. Which electrolyte abnormality could cause toxic effects? • Low potassium • Low sodium • Low calcium • Iron deficiency Pharm Review-LDavis-2007

  14. Question 10 • Which of the following ENHANCES the effects of narcotic analgesics? • Naloxone (Narcan) • Flumazenil (Romazicon) • Lidocaine (Xylocaine) • Ethanol (Alcohol) Pharm Review-LDavis-2007

  15. Question 11 • What is the most serious side effect that would need to be assessed for with a pt starting selective serotonin reuptake inhibitor (SSRI) therapy? • Nausea &Vomiting • Increased suicidal ideations/attempts • Sleep pattern disturbance • Food/Drug interaction Pharm Review-LDavis-2007

  16. Question 12 • Levothyroxine (Synthroid) is prescribed for a patient. The RN teaches the pt to check their HR and notify the MD/NP if their pulse is > 100 bpm because: • Tachycardia may be an allergic reaction caused by this medication • Excessive levels of the drug result in tachycardia • Prolonged cardiac workload can occur as a result of increased weight gain • Congestive heart failure can occur related to the fluid and electrolyte shifts caused by the med Pharm Review-LDavis-2007

  17. Question 13 • Acetaminophen (Tylenol) should be used with caution in which clients? • Older adults with arthritis and dementia • Children with chicken pox and a fever • Pregnant women and teenagers with anemia • Clients with chronic alcoholism and hepatic disease Pharm Review-LDavis-2007

  18. Question 14 • What medication is the antidote to acetaminophen toxicity? • Furosemide (Lasix) • Acetylcysteine (Mucomyst) • Heparin • Activated charchoal • There is no antidote Pharm Review-LDavis-2007

  19. Question 15 • Pilocarpine (Pilocar) ocular therapy is prescribed for a client. The nurse would expect this client to have which medical condition? • Glaucoma • Amblyopia • Astigmatism • Cataracts Pharm Review-LDavis-2007

  20. Question 16 • An RN is providing education to a patient/family about proper use of a PCA Pump. What statement would indicate patient/family understanding? • Family member stating that they will hit the button when they think the patient needs it • Pt states that they will wait until the pain is very bad to use the pump • Pt states that they will use the pump to keep their pain at comfortable level • Pt states that they will wait till the nurse is in the room to use the PCA Pharm Review-LDavis-2007

  21. Question 17 • Antacids containing magnesium may increase the risk of adverse physical effects in clients with which condition: • Viral infection • Cardiac disease • Diabetes mellitus • Renal failure Pharm Review-LDavis-2007

  22. Question 18 • Which category of meds used to treat asthma work by promoting smooth muscle relaxation while dilating the constricted bronchi and bronchioles? • Beta-adrenergic agents • Antihistamines • Corticosteroids • Anticholinergics Pharm Review-LDavis-2007

  23. Question 19 • A client who is taking a benzodiazepine for anxiety asks what kinds of medications he might need to avoid. The nurse would respond: • Cephalosporin antibiotics • Nonsteroidal anti-inflammatory drugs • Calcium channel blockers • Barbituates Pharm Review-LDavis-2007

  24. Question 20 • A client is receiving morphine sulfate IV for post-op pain. Which assessment finding would warrant immediate attention? • Blood Pressure 150/90 • Pulse Rate = 110 • Pupillary constriction • Respiratory rate = 9 Pharm Review-LDavis-2007

  25. Some Helpful Things You Might Want to Know….. Pharm Review-LDavis-2007

  26. Insulin Pharm Review-LDavis-2007

  27. Helpful Websites • www.eriworld.com • www.cdc.gov • www.rxlist.com • This has the top 200 drugs for 2002. • www.rx.com Pharm Review-LDavis-2007

  28. THANK YOU FOR COMING AND GOOD LUCK!!!! Review material from ATI testing, Kaplan Review, and Eileen Horn RN MSN Pharmacology Review. Compiled by Lindsey Austin Pharm Review-LDavis-2007

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