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Microsoft word - core concepts exam 3 chap 9-11 fall 2010.rtf

Exam Core Concepts Pharmacology Units 9-11 Fall 2010 Please complete this test on your own using your lecture notes, textbook and drug book. MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) The nurse is caring for a client receiving morphine sulfate 2—4 mg IV every 4 hours as needed for pain. The client's family calls the nurses' station to request pain medication for the client. When the nurse arrives in the room, the client is lying in the bed. The nurse obtains the following vital signs: BP 120/80, P 80, and R 8. What is the nurse's first action? A) Call the physician after giving the pain medication. B) Call the physician. C) Withhold the medication. D) Find out when the client had the last dose of medication. 2) The nurse is discharging a client to home with a prescription for clarithromycin (Biaxin). The nurse knows that the teaching has been effective when the client states: A) "I can quit taking this medication when I feel better." B) "I cannot clean house while taking this medication." C) "I cannot drive while taking this medication." D) "I need to take the medication until it is gone." 3) Mineralocorticoids, glucocorticoids, and androgens are released by: A) The pituitary gland. B) The thyroid gland. C) The adrenal glands. D) The pancreas. 4) The nurse is admitting a client to the floor with a protozoan infection. Which of the following medications would the nurse expect the physician to order? A) Metronidazole (Flagyl) B) Quinupristin-dalfopristin (Synercid) C) Ciprofloxacin (Cipro) 5) A client arrives in the Emergency Department with an overdose from benzodiazepines. The nurse knows death is very likely if the client: A) Has never taken a benzodiazepine before. B) Took a high dose of benzodiazepines. C) Combined benzodiazepines with a CNS stimulant. D) Has taken a benzodiazepine with a CNS depressant. 6) The nurse needs to monitor the client's blood sugar after administration of Humulin R. Peak action will occur in: D) 15—30 minutes. 7) The nurse knows one way to decrease the chance of addiction to a prescription drug is to take A) Lowest effective dose for the shortest time necessary. B) Highest dose possible for the shortest time necessary. C) Lowest effective dose for the longest time necessary. D) Highest dose possible for the longest time necessary. 8) A client asks the nurse what the two most commonly abused drugs are. The nurse replies: A) "Alcohol and marijuana." B) "Alcohol and nicotine." C) "LSD and marijuana." D) "Marijuana and nicotine." 9) It is important for the nurse to teach a client to avoid when taking barbiturates. 10) A client arrives in the Emergency Department with a barbiturate overdose. The nurse knows that which of the following are possible? Select all that apply. B) Decreased respirations C) Increased respirations 11) The nurse is caring for a client who has a morphine PCA. Which of the following medications should the nurse ensure is readily available? A) Butorphanol tartrate (Stadol) B) Meperidine (Demerol) C) Naloxone hydrochloride (Narcan) D) Naltrexone hydrochloride (Trexan) 12) Which of the following statements are true regarding pain medications? Select all that apply. A) Opioids act at the peripheral level. B) NSAIDs act at the peripheral level. C) NSAIDs act within the CNS. D) Opioids act within the CNS. 13) A client is receiving treatment for opioid addiction. The nurse expects which medication to be prescribed to help treat this addiction? A) Methadone (Dolphine) B) Hydromorphone (Dilaudid) C) Propoxyphene (Darvon) D) Fentanyl (Druagesic) 14) The client asks the nurse which type of diabetes is caused by a lack of insulin secretion by the pancreas. The nurse replies: A) "Neither–they both result from the inability of the body to use insulin." B) "Both type I and II." C) "Type I." D) "Type II." 15) A client has been prescribed penicillin (Penicillin G). The nurse knows that the most serious adverse effect is: 16) A client complains of slowed body metabolism, slurred speech, bradycardia, weight gain, low body temperature, and intolerance to cold environments. The nurse knows that these are symptoms of: A) Hypothyroidism. B) Hyperthyroidism. C) Type II diabetes. D) Type I diabetes. 17) A client complains of pain that is a generalized dull, throbbing, or aching pain. The nurse understands this type of pain is: B) Somatic pain. C) Visceral pain. D) Neuropathic pain. 18) Which of the following instructions should the nurse provide to the client prescribed a benzodiazepine? Select all that apply. A) Report significant mood changes. B) Avoid OTC medications used to induce sleep. C) If a dose is missed, the client should take a double dose as soon as possible. D) Avoid alcoholic beverages. 19) The client received lispro (Humalog) insulin with breakfast. Two hours later, the client Experiences tachycardia, confusion, sweating and drowsiness. The nurse understands that these Symptoms are caused by: B) Hyperglycemia C) Allergice reaction to lispro (Humalog) D) Myocardial Infarction 20) The nurse is caring for a client receiving gentamicin IV. Which of the following adverse effects would the nurse report to the physician immediately? A) Increased urinary output 21) A sputum culture has been collected and sent for culture and sensitivity. The physician orders a broad-spectrum antibiotic. The nurse understands that the reason for this is: A) Treatment for severe infections is started on broad-spectrum antibiotics while the culture is pending and then changed to a narrow-spectrum antibiotic. B) The broad-spectrum antibiotic will cure the infection before the culture results are ready. C) The culture and sensitivity will take 2 weeks for the results to be available. D) Most people are allergic to narrow-spectrum antibiotics. 22) The nurse is instructing a client who has been prescribed tetracycline (Sumycin). The nurse advises the client to avoid: B) Taking with food. D) Foods that contain wheat. 23) The nurse is preparing discharge instructions for a client who will be taking penicillin G. The client tells the nurse she is also taking birth control pills. What is the nurse's best response? A) "You will need to use another form of contraception while taking the antibiotic and for at least one month after you finish treatment." B) "You may continue taking the birth control pills as your only means of contraception." C) "You do not need to take your birth control pills while taking this medication." D) "If you feel you do not need to take the antibiotic, that is fine." 24) The nurse is performing the AM assessment on a client who is postoperative cholecystectomy. The client states he needs his pain medication. The client has meperidine (Demerol) 50 mg. IM ordered for pain. Which of the following must be assessed before administering a narcotic? A) The intensity of the pain only B) The quality, intensity, location, and duration of pain C) The quality of the pain only D) The last time the client had a bowel movement 25) The nurse is planning care for a client receiving an antiretroviral agent. Which of the following nursing diagnoses should be the priority? A) Self-care deficit B) Risk for infection D) Deficient knowledge 26) A client has been diagnosed with tuberculosis. The nurse would anticipate treatment to continue A) 10—14 days. B) 6—12 months. C) 3—6 months. 27) The nurse understands that the difference between bacteriostatic and bacteriocidal medications A) That bacteriocidal medications kill bacteria, and bacteriostatic medications slow the growth of bacteria. B) Bacteriostatic medications must be given first. C) That bacteriocidal medications slow the growth of bacteria, and bacteriostatic medications D) Both terms have the same meaning. 28) The client asks which type of medications will be given for severe pain. The nurse replies that is/are the drug of choice for moderate-to-severe pain. B) Acetaminophen (Tylenol) C) Beta blockers 29) Hormone replacement therapy (HRT) is used to treat symptoms of menopause. Data suggest that women who utilize HRT have increased risk for which of the following? Select all that apply. A) Breast cancer B) Venous thromboembolism D) Endometrial cancer 30) Long-term therapy with corticosteroids can produce a variety of adverse effects, including which of the following? Select all that apply. A) Sodium retention C) Increased risk for infections D) Delayed wound healing



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Implementation of QbD for Existing Products An Example from GSK Australia Jonathan Parks B.Sc (Hons) from Monash University in 1990 Started at Glaxo (as it was called then) in 1991 as a Development Chemist in Pharmaceutical Development Worked on the development of Blow-Fill-Seal (BFS) products for nebulisation and Dry Powder Inhalation (DPI) products