Question

Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?

Answer 1

Correct Answers:

Increased placental surface area

Rationale :

🤰Drug transfer from the mother to the fetus becomes greater during the last trimester because the placenta enlarges and becomes more efficient at exchange between maternal and fetal circulation.

🫄An increased placental surface area allows more medications and substances to cross by diffusion, increasing fetal exposure to drugs during late pregnancy.

💊As pregnancy progresses, the placenta develops thinner membranes and improved circulation, which enhances the movement of many drugs from the mother to the fetus.

📖The other options are incorrect because protein-bound drugs cross the placenta less easily, and changes in fetal surface area are not the primary factor influencing drug transfer.

📌Core message

An increased placental surface area in the third trimester allows more efficient transfer of drugs from the mother to the fetus.

Answer 2

Correct Answers:

Glomerular filtration rate (GFR)

Rationale :

🩺Glomerular filtration rate (GFR) is the best overall indicator of kidney function because it reflects how effectively the kidneys are filtering waste products from the blood.

🧪In patients with acute kidney injury, improvement in GFR indicates recovery of the kidneys’ filtering ability and restoration of renal perfusion.

💉Although BUN, creatinine, and urine output are useful, they can be affected by factors such as hydration, diet, and medications, making them less accurate indicators of overall kidney recovery.

📚A rising or stabilizing GFR provides the clearest picture of functional kidney improvement and is widely used to stage kidney disease and monitor progression.

📌Core message

GFR is the most accurate indicator of overall kidney function and recovery in patients with AKI.

Answer 3

Correct Answers:

Administering antinausea drugs 30 to 60 minutes before chemotherapy is started
Instructing the patient that the antinausea drugs may cause extreme drowsiness
Observing carefully for the adverse effects of restlessness and anxiety

Rationale :

💊Antiemetic medications are most effective when given 30 to 60 minutes before chemotherapy because they help prevent nausea before it begins.

😴Many antinausea drugs can cause significant drowsiness or sedation, so patients should be warned to avoid activities requiring alertness if affected.

👀Certain antiemetics may produce adverse effects such as restlessness, anxiety, or extrapyramidal symptoms, requiring careful nursing observation.

📖Waiting until nausea begins decreases the effectiveness of therapy because prevention is more effective than treating established symptoms during chemotherapy.

📌Core message

Antiemetics should be given before chemotherapy and monitored carefully for sedation and neurologic adverse effects.

Answer 4

Correct Answers:

Vancomycin

Rationale :

🦠Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to many common antibiotics, making treatment selection very important.

💉Vancomycin is a commonly used antibiotic for serious MRSA infections because it is effective against resistant gram-positive organisms.

🏥Patients hospitalized for prolonged periods are at increased risk for acquiring multidrug-resistant infections, especially in wounds such as pressure ulcers.

📚The other medications listed are not considered first-line therapy for serious MRSA skin and soft tissue infections.

📌Core message

Vancomycin is a key antibiotic used in the treatment of serious MRSA infections.

Answer 5

Correct Answers:

Tingling in the thumb and index finger

Rationale :

✋A positive Tinel’s sign occurs when tapping over the median nerve produces tingling or numbness in areas supplied by the nerve.

🖐️In carpal tunnel syndrome, the median nerve is compressed at the wrist, commonly causing symptoms in the thumb, index finger, and middle finger.

⚡Patients often describe sensations such as tingling, burning, or numbness that worsen with repetitive hand movements.

📚Weakness in the little finger or elbow pain would suggest involvement of other nerves rather than the median nerve.

📌Core message

A positive Tinel’s sign in carpal tunnel syndrome commonly causes tingling in the thumb and index finger.

Answer 6

Correct Answers:

Administer the prescribed fluid bolus and insulin.

Rationale :

🩸Rapid, deep respirations in diabetic ketoacidosis (DKA) are known as Kussmaul respirations and occur as the body attempts to correct metabolic acidosis.

💉The priority treatment for DKA includes intravenous fluids and insulin, which correct dehydration, hyperglycemia, and acidosis.

🫁These respirations are compensatory and should not be slowed intentionally because they help remove excess carbon dioxide from the body.

📚Administering fluids and insulin addresses the underlying cause of the acidosis rather than only treating the symptoms.

📌Core message

DKA is treated by correcting dehydration and hyperglycemia with fluids and insulin therapy.

Answer 7

Correct Answers:

The duration of action of the medication will be longer.

Rationale :

💊Protein-bound medications attach primarily to albumin in the bloodstream, leaving less free drug immediately available for action.

🕒Because only the unbound portion is active, highly protein-bound drugs are released more slowly over time, resulting in a longer duration of action.

🩺This slower release can prolong therapeutic effects and sometimes increase the risk for drug interactions if displacement occurs.

📚Drugs that are not highly protein bound tend to act and be eliminated more quickly because more free drug circulates immediately.

📌Core message

Highly protein-bound drugs usually remain in circulation longer and have a prolonged duration of action.

Answer 8

Correct Answers:

"Do you use any over-the-counter drugs?"

Rationale :

💊Many over-the-counter medications, especially acetaminophen and herbal supplements, can cause drug-induced liver injury and hepatitis.

🟡When viral hepatitis testing is negative, the nurse should investigate possible exposure to substances that may damage the liver.

🩺Drug-induced hepatitis often presents with symptoms such as jaundice, nausea, and elevated liver enzymes similar to viral hepatitis.

📚Identifying potentially hepatotoxic medications is important for preventing further liver damage and guiding treatment decisions.

📌Core message

Over-the-counter medications and supplements are important causes of drug-induced hepatitis.

Answer 9

Correct Answers:

"I will measure my output each day to help calculate the amount I can drink."

Rationale :

🩺Patients with stage 5 chronic kidney disease often require fluid restriction because the kidneys cannot adequately remove excess fluid.

💧Measuring daily urine output helps determine safe fluid intake and reduces the risk of fluid overload, edema, and hypertension.

🩸Erythropoietin is used to treat anemia associated with CKD, not to improve immunity or prevent infection.

📚Patients with advanced CKD usually need restrictions in potassium, phosphorus, and sometimes protein rather than increasing fruits, vegetables, or dairy intake excessively.

📌Core message

Monitoring urine output helps guide safe fluid intake in patients with advanced CKD.

Answer 10

Correct Answers:

Administer the spironolactone.

Rationale :

🩸A potassium level of 3.2 mEq/L indicates hypokalemia, which can lead to dangerous cardiac dysrhythmias and muscle weakness.

💊Spironolactone is a potassium-sparing diuretic that helps retain potassium while promoting fluid removal in patients with cirrhosis.

🚫Furosemide can further decrease potassium levels because it is a loop diuretic associated with potassium loss.

📚Administering spironolactone while withholding furosemide helps correct hypokalemia and maintain safer electrolyte balance.

📌Core message

Spironolactone helps preserve potassium and is preferred when hypokalemia is present.

NUR 3420 Pharmacology II Final Exam

No.

1 :
Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?

2 :
A patient is hospitalized with acute kidney injury (AKI). Which information will be most useful to the nurse in evaluating improvement in kidney function?

3 :
A patient is on a chemotherapy regimen in an outpatient clinic and is receiving a chemotherapy drug that is known to be highly emetogenic. The nurse will implement which interventions regarding the pharmacologic management of nausea and vomiting? Select the 3 that apply.

4 :
A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy?

5 :
A patient has possible carpal tunnel syndrome. Which symptom would the nurse expect with a positive Tinel's sign?

6 :
A patient who was admitted with diabetic ketoacidosis has rapid, deep respirations. Which action would the nurse take?

7 :
When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound?

8 :
A patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function studies, but serologic testing is negative for viral causes of hepatitis. Which question would the nurse ask?

9 :
Which statement by a patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective?

10 :
A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis who has scheduled doses of spironolactone and furosemide due. Which action would the nurse take?

NUR 3420 Pharmacology II Final Exam

No.

1 : Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?

2 : A patient is hospitalized with acute kidney injury (AKI). Which information will be most useful to the nurse in evaluating improvement in kidney function?

3 : A patient is on a chemotherapy regimen in an outpatient clinic and is receiving a chemotherapy drug that is known to be highly emetogenic. The nurse will implement which interventions regarding the pharmacologic management of nausea and vomiting? Select the 3 that apply.

4 : A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy?

5 : A patient has possible carpal tunnel syndrome. Which symptom would the nurse expect with a positive Tinel's sign?

6 : A patient who was admitted with diabetic ketoacidosis has rapid, deep respirations. Which action would the nurse take?

7 : When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound?

8 : A patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function studies, but serologic testing is negative for viral causes of hepatitis. Which question would the nurse ask?

9 : Which statement by a patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective?

10 : A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis who has scheduled doses of spironolactone and furosemide due. Which action would the nurse take?

1 :
Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?

2 :
A patient is hospitalized with acute kidney injury (AKI). Which information will be most useful to the nurse in evaluating improvement in kidney function?

3 :
A patient is on a chemotherapy regimen in an outpatient clinic and is receiving a chemotherapy drug that is known to be highly emetogenic. The nurse will implement which interventions regarding the pharmacologic management of nausea and vomiting? Select the 3 that apply.

4 :
A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy?

5 :
A patient has possible carpal tunnel syndrome. Which symptom would the nurse expect with a positive Tinel's sign?

6 :
A patient who was admitted with diabetic ketoacidosis has rapid, deep respirations. Which action would the nurse take?

7 :
When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound?

8 :
A patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function studies, but serologic testing is negative for viral causes of hepatitis. Which question would the nurse ask?

9 :
Which statement by a patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective?

10 :
A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis who has scheduled doses of spironolactone and furosemide due. Which action would the nurse take?