Question 1

A client smokes regularly. She takes theophylline (Theo-Dur and others) daily. What is an effect of smoking while on theophylline?

Accepted Answer

Smoking increases hepatic enzyme activity, increasing the clearance of theophylline (Theo-Dur and others). Smokers may need an increased dose of medication.

Question 2

The nurse is aware that drugs can block, decrease, or increase the actions of another drug. Laxatives can have which effect on drug absorption?

Accepted Answer

Laxatives increase gastric and intestinal emptying, decreasing the time the medication is in contact with the gastric lining and is available for drug absorption.

Question 3

A client receives morphine sulfate and demonstrates signs of respiratory depression. The physician orders naloxone (Narcan) to block the effects of the narcotic. When two drugs given concurrently have opposite effects, what kind of pharmacodynamic interactions occur?

Accepted Answer

When two drugs that have opposite effects, or antagonistic effects, are administered together, each drug cancels the effect of the other.

Question 4

The nurse instructs a client with which condition to avoid taking over-the-counter cough and cold remedies?

Accepted Answer

Clients with heart disease, hypertension, and thyroid disease should avoid taking over-the-counter cough and cold preparations as they may contain sympathomimetics, which may increase blood pressure and cause nervousness, headache, and insomnia.

Question 5

A client is taking tetracycline for acne. It is a drug known to cause photosensitivity. To avoid phototoxicity, the nurse provides client teaching. Which statement by the client indicates a need for more teaching?

Accepted Answer

Four hours would be too long to be exposed, especially during peak sunlight times.

Question 6

A nurse is monitoring for drug interactions based on which premise about drug interactions?

Accepted Answer

Drug interactions are an altered or modified action or effect of a drug as a result of interaction with one or more other drugs.

Question 7

The nurse is caring for a client who is being treated with aspirin and an oral antidiabetic agent. The nurse anticipates an increased risk of _____ from the interaction between the drugs.

Accepted Answer

Oral antidiabetic agents, when taken with aspirin, can increase the risk of hypoglycemia.

Question 8

Cimetidine (Tagamet) is an enzyme inhibitor for the medication theophylline. Drugs that are enzyme inhibitors:

Accepted Answer

An enzyme inhibitor decreases the metabolism of certain drugs.

Question 9

Some medications previously requiring a prescription are now available as over-the-counter (OTC) drugs. Client teaching related to OTC drugs should include:

Accepted Answer

OTC medications may interact with prescribed medications or may have certain effects that should be evaluated by a healthcare provider.

Question 10

A client is scheduled for surgery, and an antihistamine and narcotic have been prescribed as preoperative drugs. The antihistamine increases the effect of the narcotic. This is an example of which drug effect?

Accepted Answer

Potentiating drugs include those with different actions that when given together increase the function of one another.

Question 11

The nurse has provided instructions to a client taking diazepam (Valium) for short-term anxiety. Which statement by the client indicates that the client needs additional instruction?

Accepted Answer

Flavanoids are found in grapefruit, and taking diazepam (Valium) with grapefruit may increase drug levels. The other statements are appropriate.

Question 12

Narcotics and anticholinergic drugs (atropine-like drugs) decrease gastrointestinal (GI) motility. Decreasing GI motility has what effect on drug absorption?

Accepted Answer

Because of slower gastric emptying time, drugs have more chance to be absorbed.

Question 13

A client is ordered to receive warfarin (Coumadin), which is highly protein bound. Another medication that is equally highly protein bound is ordered. The nurse anticipates that the dosage will be:

Accepted Answer

When drugs are equally protein bound, they will vie for receptor sites. More of both drugs will be displaced, allowing for a greater level of medication activity.

Question 14

A client is taking antacids with an antibiotic. The nurse's instructions are based on the fact that antacids such as aluminum hydroxide (Amphojel) can:

Accepted Answer

Antacids impair medication absorption by changing the pH and surface area of the gastric lining. Many drugs are formulated to be absorbed in an acidic environment, and antacids make the environment more alkaline.

Question 15

A client with a history of deep vein thrombosis takes warfarin (Coumadin) daily. He has been experiencing headaches and has been taking over-the-counter pain relievers. The nurse discovers that the client is taking aspirin. Which assessment should the nurse be most attentive to at this time?

Accepted Answer

Aspirin and warfarin both increase the bleeding time. An early manifestation of this is bleeding from the gums.

Question 16

Food is known to increase, decrease, or delay drug absorption. A client has a high serum cholesterol level, and lovastatin (Mevacor) is prescribed. The client is taking the drug at mealtime and asks why this is necessary. What does taking lovastatin with food accomplish?

Accepted Answer

The absorption of the statin medications is increased in the presence of food.

Question 17

A client is receiving two analgesics for pain relief. Two drugs with similar action are administered to achieve which kind of effect?

Accepted Answer

Additive drugs include those with similar actions that increase the function of one another when given together.

Question 18

The nurse is caring for a client who is being treated with both isoniazid and phenytoin. The nurse anticipates which result from the interaction between the drugs?

Accepted Answer

Administering isoniazid along with phenytoin may result in phenytoin developing toxic levels.

Question 19

Some drugs can affect the excretion of other drugs. The antidysrhythmic drug quinidine decreases the excretion of digoxin (Lanoxin). How would the digoxin concentration in the body fluids be affected?

Accepted Answer

Because the excretion of digoxin (Lanoxin) is decreased, this would allow the digoxin to accumulate in the bloodstream.

Question 20

A client eats a large meal and then takes her medications. Usually food has which effect on drug dissolution and absorption?

Accepted Answer

Food typically delays drug absorption, although it occasionally has other effects.

Quiz 8: Drug Interactions and Over-The-Counter Drugs