Chapter 107 Additional Noteworthy Drugs

Chapter 107  Additional Noteworthy Drugs

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A patient who has pulmonary arterial hypertension (PAH) is receiving epoprostenol [Flolan] at a rate of 210 ng per minute using a portable pump. The patient weighs 70 kg. The patient calls the clinic to report headache, nausea, and vomiting. The nurse will counsel the patient to:
a.
decrease the infusion to 100 ng per minute.
b.
discuss these side effects with the provider.
c.
prepare for a hospital admission.
d.
stop the infusion and contact the provider.

ANS: B
Headache, nausea, and vomiting are common side effects of epoprostenol and are dose dependent. Patients should contact their provider to discuss these side effects and any necessary dosage adjustments. 100 ng per minute is below the maintenance dose range for this patient; patients should not adjust doses without contacting the provider. The side effects are not serious and do not warrant hospitalization. Interruption of the drug can have life-threatening consequences.

PTS: 1 DIF: Cognitive Level: Application REF: pp. 1302-1303
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

2. The nurse provides teaching for a patient who will begin taking bosentan [Tracleer] for pulmonary arterial hypertension (PAH). Which statement by the patient indicates a need for further teaching about this medication?
a.
“I may take this medication with or without food.”
b.
“I may develop irreversible liver damage while taking this drug.”
c.
“I should not take cyclosporine while taking this medication.”
d.
“I will need to have lab tests every month while taking this drug.”

ANS: B
Liver injury may occur with bosentan but all cases to date have been reversible. The medication may be taken without regard to meals. Patients taking bosentan should not take cyclosporine concurrently. Patients will need to have liver enzymes measured monthly while taking the drug.

PTS: 1 DIF: Cognitive Level: Application REF: pp. 1303-1304
TOP: Nursing Process: Planning
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

3. A patient with a history of heart disease develops pulmonary arterial hypertension (PAH), and the provider is considering prescribing sildenafil [Revatio]. The nurse caring for this patient will perform a careful drug history and notify the provider if the patient is taking which medication?
a.
A beta blocker
b.
A calcium channel blocker
c.
Nitroglycerin
d.
Warfarin

ANS: C
Patients taking sildenafil should not take nitroglycerin, since the combination can produce a life-threatening drop in blood pressure. Beta blockers, calcium channel blockers, and warfarin are not contraindicated with sildenafil.

PTS: 1 DIF: Cognitive Level: Application REF: pp. 1304-1305
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

4. A nurse is caring for a premature infant who has received poractant alfa [Curosurf] 2.5 mL/kg via direct intratracheal instillation to prevent respiratory distress syndrome. The infant demonstrated initial improvement after the dose but has begun to deteriorate. Which treatment will the nurse expect the neonatologist to order?
a.
A repeat dose of 1.25 mL/kg of poractant alfa
b.
A repeat dose of 2.5 mL/kg of poractant alfa
c.
A repeat dose of 5.0 mL/kg of poractant alfa
d.
Administration of high-dose glucocorticoids

ANS: A
When poractant alfa is given, subsequent doses are half the initial doses. Glucocorticoids are given prenatally; their use postnatally is in dispute.

PTS: 1 DIF: Cognitive Level: Application REF: pp. 1305-1306
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies