Pharm Exam 1

Question 1

Hypokalemia symptoms/abnormalities

Answer 1

Gi upset (ileus), dysrhythmias (depressed STs, gives us U-waves)

Question 1

Hyperkalemia symptoms/abnormalities

Answer 1

dysrhythmias, elevated T waves

Question 2

Hypermagnesemia symptoms/abnormalities

Answer 2

hyporeflexia, dec DTRs, depressed respiratory rate, muscle weakness, hypotension

Question 3

Hypomagnesemia symptoms/abnormalities

Answer 3

seizures, hyperreflexia

Question 4

Special considerations when given potassium via IV route:

Answer 4

• DO NOT PUSH
• Dilute

Question 5

the fastest route of administration?

Answer 5

IV

Question 6

the slowest route of medical administration

Answer 6

oral

Question 7

Where to inject an IM injection

Answer 7

big large muscle groups

Question 8

what not to do with sublingual

Answer 8

don’t swallow it

Question 9

Subq administration?

Answer 9

rotate sites, 45 vs 90 degrees

Question 10

Isotonic: Saline 0.9%: purpose and effects

Answer 10

for fluid resuscitation, stays in the vascular; can also give lactated ringers

Question 11

Hypotonic: D5W: purpose and effects

Answer 11

(drops sodium level), 0.45% NaCl (fluid goes into tissue cells)

Question 12

Hypertonic: 3% Saline

Answer 12

inc. sodium level very rapidly, pulling from cells into vascular space (fluid out of cells)

Question 13

best drugs for hypertension during pregnancy aka preclampsia (in order)

Answer 13

magnesium first
then Labetalol

Question 14

what is the “ideal drug”

Answer 14

effective, safe, selective

Question 15

When to give a patient grapefruit juice?

Answer 15

NEVER! DON’T BE DUMB
it contradicts and messes up so many meds, better safe than sorry

Question 16

What is the MONA acronym used for?

Answer 16

Goal for treating a heart attack

Question 17

what does MONA stand for?

Answer 17

M – morphine (pain med)
O – oxygen (if needed)
N – Nitro (affects pre-load, so don’t give to r-side, it’ll open up vessels and reduce pre-load)
A – Aspirin (antiplatelet)

Question 18

4 steps if you give the patient the wrong med

Answer 18

1. Assess! (make sure they’re not dead)
2. Call the provider
3. Document VS and that patient is OK
4. Make sure you call the pharmacy team and ask them what I should watch for – “Are any of their current medications going to interact with what I just accidentally gave them?”

Question 19

6 patient rights:

Answer 19

right patient. …
right medication. …
indication for use. …
right dose. …
right time. …
right route.

Question 20

which category of drug do you not give to a pregnant woman?

Answer 20

category X

Question 21

which category of drug is safe and good to give a pregnant woman?

Answer 21

category A- yay folic acid

Question 22

what to do before prescribing a woman a medication

Answer 22

have them take a pregnancy test! doesn’t matter what they say about their sexual history

Question 23

best way to ensure patient compliance

Answer 23

• only a once-a-day medication
• combination drugs

Question 24

difference between schedule 1 and 2 drugs

Answer 24

schedule 1 is not prescribed or used for medical use schedule 2 is used for medicine

Question 25

what is ROME?

Answer 25

respiratory opposite metabolic equal

Question 26

what ABG is needed for metabolic acidosis?

Answer 26

PH low HCO3 low

Question 27

what ABG is needed for metabolic alkalosis

Answer 27

PH high HCO3 high

Question 28

what ABG is needed for respiratory acidosis

Answer 28

PH low PCO2 high

Question 29

what ABG is needed for respiratory alkalosis

Answer 29

PH high PCO2 low

Question 30

normal PH range

Answer 30

7.35-7.45

Question 31

normal CO2 range

Answer 31

35-45

Question 32

normal HCO3 range

Answer 32

22-26

Question 33

where does excretion primarily happen?

Answer 33

kidneys

Question 34

what should we do with a dose if someone has renal injury/failure

Answer 34

lower the dose

Question 35

medication consideration when a mother is breastfeeding

Answer 35

excretion can happen in breast milk too. Make sure it's safe for both mom AND baby

Question 36

what is the first-pass effect?

Answer 36

a phenomenon where medication metabolizes and becomes less strong

Question 37

which medications have a first-pass effect

Answer 37

oral meds- metabolize in GI

Question 38

what is a loading dose?

Answer 38

giving patients more than possible necessary to hit the therapeutic range faster

Question 39

what do we do after a loading dose?

Answer 39

once in the therapeutic range, then we drop the dose down

Question 40

agonist vs antagonist drug

Answer 40

- Agonist: stimulates - Antagonist: blocks

Question 41

what is nitro used for?

Answer 41

angina aka during heart attack

Question 42

who shouldn't get nitro and why

Answer 42

people on viagra, their BP will drop

Question 43

purpose of ACE inhibitors

Answer 43

lower BP

Question 44

ACE inhibitors have unintended side effects

Answer 44

- Unintended: angioedema (will kill you)*, cough *stridor and inability to control secretions

Question 45

BEERS criteria

Answer 45

-used for geriatric patients -list of potentially dangerous medications considering the patient

Question 46

what to do if the patient fits the BEERS criteria

Answer 46

- Monitor them closely (don’t take them off just because u want to; not necessarily recommended, but its better for THEM)

Question 47

Digoxin what are the nursing interventions

Answer 47

Monitor apical pulse for a full min (must be above 60) PMI – 5th ICS MCL

Question 48

what is digoxin used for

Answer 48

myocardial infarction

Question 49

Which medications are options for ventricular rhythms

Answer 49

Ventricular: Lidocaine and amnio

Question 50

Which medications are options for atrial rhythms

Answer 50

Atrial: calcium channel blockers and beta blockers

Question 51

Ezetimibe

Answer 51

-2nd line drug for cholesterol management -Used for patients w/ myopathies they have really bad muscle cramps)

Question 52

how to dose for pediatrics

Answer 52

BSA body surface area

Question 53

how to dose for geriatrics

Answer 53

lowest dose w/ greatest effect

Question 54

what are diuretics used for

Answer 54

used for patients with fluid excess

Question 55

Statins – who should be on them? Who should not be prescribed a statin?

Answer 55

For high cholesterol (high LDL); pregnant people shout NOT be on statins

Question 56

Adenosine – expected findings and use

Answer 56

- Asystole: blocks cardiac conduction for 10 seconds - Used for SVT (supraventricular tachycardia) heart stoppy med

Question 57

Side effects of centrally acting Alpha2 (Clonidine)

Answer 57

- Reflex HTN - Benefit of med: its oral! (so cool)

Question 58

Calcium channel blockers which ones are mainly used for lower blood pressure peripherally versus controlling the heart rate?

Answer 58

- Verapomil and Cardiziam which one is which???

Question 59

- Blood pressure meds usually end with what spelling

Answer 59

: end in -pine (ex. Amlodipine; good for BP management on patients w/ bad kidneys)

Question 60

Diuretics – potassium sparing versus non potassium sparing

Answer 60

- Potassium sparing: spironolactone (NOT. FOR. RENAL. FAILURE) - Non sparing: Lasix (monitor; AE: ototoxicity) and hydrochlorothiazide

Question 61

Beta blocker usage – which medications are cardio versus non cardio selective? Why would one be favored over the other?

Answer 61

Nonselective: Propanolol (watch for b2 antagonist bronchoconstriction). selective: Metoprolol, Carvedilol (best for BP; acts on alpha) HR is expected to decrease w/ beta blockers