‫‪Meditation‬‬

‫—‪ Heparin‬مسيل للدم‪.‬‬

‫عند إعطاء المريض دواء الهيبارين اعمل فحص ‪ ptt‬حتى ما يحدث عنده ‪ bleeding‬وإذا حدث نزيف نعطي المريض‬
‫دواء مضاد اسمه ‪protamine sulfate‬‬

‫—‪ Warfarin‬مسيل للدم‪.‬‬

‫‪FI‬‬
‫عند إعطاء المريض دواء الوارفارين ننتبه لـ ‪ pt‬حتى ما يحدث للمريض نزيف ‪،‬وإذا حدث نزيف نعطي المريض دواء‬
‫مضاد يسمى ‪vitamin k‬‬

‫‪AI‬‬
‫‪LF‬‬
‫—‪Aspirin—anti platelets‬‬
‫دواء يمنع التخثر ‪.‬‬

‫‪_A‬‬
‫—‪Plavix—anti platelets‬‬
‫ضد التخثر‪.‬‬

‫‪AN‬‬ ‫—‪Clexan‬مسيل للدم‬

‫—‪Streptokinase‬مذيب للجلطه‬
‫‪M‬‬
‫‪AH‬‬

‫‪Digoxin—increase force of heart contraction‬‬

‫* يزيد قوة عضلة القلب‪.‬‬
‫* يزيد قوة العضلة وليس النبض ‪.‬‬
‫‪R‬‬

‫* الدايجوكسين موجود بالدم بشكل طبيعي ونسبته من ‪.2-0,5‬‬

‫* اذا زادت نسبته في الدم عند المريض يحث عنده ‪toxic .‬‬
‫‪U‬‬

‫* كيف نعرف انه صار ‪ toxic‬اذا زادت نسبته عن ‪ 2‬وكمان اذا ظهرت عنده األعراض التالية ‪-:‬‬
‫‪# Nausea diarrhea vomiting loss of appetite‬‬
‫‪BD‬‬

‫* وإذا حصل عنده ‪ toxic‬وش راح نسوي ؟‬

‫* نعطي المريض دواء مضاد يسمى‬
‫‪auto immune fab‬‬
‫‪A‬‬

‫* قبل إعطاء المريض هذا الدواء بشوف نبض المريض وإذا كان عنده ‪ bready cardia‬ال تعطي الدواء وسو له ‪hold‬‬
‫‪e/‬‬

‫—‪Morphine—-narcotic‬االدوية المخدرة‬
‫‪m‬‬

‫* يعطى لـ ‪severe pain‬‬

‫* عند إعطاء هذا الدواء انتبه لـ المضاعفات التالية ‪-:‬‬
‫‪T.‬‬

‫‪1-respiratory depression‬‬
‫‪2-severe constapation‬‬
‫‪3- hypotension‬‬
‫* وإذا حدث عند المريض هذي االمور خالل إعطاء الدواء اعطي المريض دواء مضاد اسمه نالكسون ‪naloxone‬‬

‫—‪Lasix ——diuretics‬مدل للبول‬

‫* عند إعطاء الدواء أنتبه من حدوث هايبوكاليميا للمريض نتيجة فقدان السوائل وبالتالي فقدان البوتاسيوم‪.‬‬
 ‫‪Meditation‬‬
‫—‪ Aldactone——diuretics‬مدر بول‬
‫* هذا الدواء يحتفظ بالبوتاسيوم‪.‬‬
‫* انصح المريض انه ياخد ‪low k diet‬‬
‫أكل قليل البوتاسيوم‬
‫‪——————————————-‬‬
‫‪Mannitol—diuretic—-‬مدر بول‬
‫* نستعمله معا ‪cerebral edema‬‬

‫‪FI‬‬
‫‪Adrinaline‬‬

‫‪AI‬‬
‫استخدمه مع ‪CPR‬‬
‫* في حاله توقف عضله القلب‪.‬‬

‫‪LF‬‬
‫* يستخدم كبخار مع االطفال الي عندهم مشاكل الجهاز التنفسي‪.‬‬

‫‪_A‬‬
‫‪Atropine‬‬
‫* دواء يعطى للمريض الي عنده النبض اقل من ‪50‬‬
‫* يعطى للمريض الي عنده ‪heavy secretions.‬‬
‫‪AN‬‬ ‫يعطى للمريض الي عنده تسمم من بعض المواد الكيماوية‪.‬‬
‫‪M‬‬
‫‪Azmacort,ventolin,thyphilline, solumedrol‬‬
‫* هذي االدوية موسعة للقصبات الهوائية‬
‫‪AH‬‬

‫‪Bronchodilator‬‬
‫* عند إعطاء المريض هذي االدوية انتبه لـ نبض المريض الن هذي االدوية تعمل ‪tachycardia and palpitations‬‬
‫‪* Solumedrol‬عند اعطاءه للمريض اعمل فحص السكر للمريض الن هذا الدواء يرفع السكر بالدم‪.‬‬
‫‪R‬‬
‫‪U‬‬

‫—‪Kcl‬المريض الي عنده نقص البوتاسيوم نعطيه هذا الدواء‬

‫* اذا اعطينا هذا الدواء بشكل مباشر بدون ما اسوي له ‪diluted in normal saline‬‬
‫‪BD‬‬

‫* المريض يحدث له اضطراب في عضله القلب وبالتالي حدوث الوفاة للمريض‪.‬‬

‫‪A‬‬

‫‪ Nitroglycerin—-‬حبة تحت للسان‬

‫* موسع للشرايين‬
‫‪e/‬‬

‫* نعطيها مع مريض ‪chest pain‬‬

‫‪m‬‬

‫‪Valium,epanutine,depakine, phynotoin‬‬
‫‪T.‬‬

‫* هذي االدوية نعطيها لمريض الصرع والتشنجات ‪.‬‬

‫* الدواء المضاد لـ الفاليوم هو ‪flamanozile‬‬
‫* عند إعطاء الفينيتوين انتبه لـ ‪gum bleeding‬‬
 ‫‪Meditation‬‬
‫—‪ Lithium‬يعطى مع تقلب المزاج‬
‫* اثار الدواء الجانبيه انه يزيد التبول عند المريض‬
‫* وبالتالي األطباء يزيدوا السوائل حتى يعوض السوائل الي تطلع مع البول‬

‫‪Nexium and Zantac‬‬

‫* هذي االدوية لـ حموضة المعدة‬
‫‪Nexium—proton pump inhibitors‬‬

‫‪FI‬‬
‫—‪ Adinosine‬دواء يعطى مع مريض ‪Supra ventricular tachycardia‬‬

‫‪AI‬‬
‫‪LF‬‬
‫‪ Folic acid‬نعطيه للحامل اول ‪ 4-3‬اسابيع‬
‫‪400mcg‬‬

‫‪_A‬‬
‫—‪ Isoniazid‬يعطى مع مريض الدرن‬
‫* قبل ما اعطي هذا الدواء اشوف وظائف الكبد‬
‫‪AN‬‬
‫‪M‬‬
‫‪AH‬‬
‫‪R‬‬
‫‪U‬‬
‫‪A‬‬‫‪BD‬‬
‫‪e/‬‬
‫‪m‬‬
‫‪T.‬‬
T.
M
E/
AB
D
U
R
AH
M
Medications

AN
_A
LF
AI
FI
 1-LITHIUM CARBONATE
-Lithium is commonly used as maintenance treatment of bipolar disorder.

-anti manic.

FI
-decreased hyperactivity.

AI
-best taken after meal.

LF
-increase fluid intake (3l/day) and sodium intake (3gm/day)

_A
-Questions:

1-A client taking lithium carbonate (Lithobid) started complaining of nausea,

AN
vomiting, diarrhea, drowsiness, muscle weakness, tremor, blurred vision and ringing
in the ears. The lithium level is 2 mEq/L. The nurse interprets this value as:
M
A-normal level.

B-toxic level.
AH

C-below normal level.

R

D-above normal level.

U

Explanation:
The therapeutic drug serum level of lithium is 0.6 to 1.2 mEq/L.
D

2-patient with bipolar disorder is being treated with lithium for the first time,
AB

Nurse Client should observe the client for which common adverse effect of
lithium:-
E/

A-Polyuria.
B-Hypertension
M

C-oliguria
D-Non
T.

Explanation:

side effects of lithium :-Gastrointestinal side effects: nausea and diarrhea, Polyuria
/polydipsia, Tremor, Weight Gain.
 3-which of the following glands are mainly affected by giving Lithium carbonate:-
A-Pancreas
B-Sweating gland
C-Thyroid
D-non

Explanation:

FI
Lithium induces a decrease in production of thyroxine (T4) from the thyroid gland, as
well as interference with the de-iodination of T4 to T3 (tri-iodothyronine, the

AI
metabolically active form of thyroid hormone).

4-A nurse is caring for a client with bipolar disorder, who is receiving Lithium

LF
carbonate. Before Administration of the next dose, the client complains of nausea and
vomiting and the nurse finds that the client’s lithium blood level 1.5mEq/lL. Which of

_A
the following actions is considered Apriority?

A-call the client’s physician immediately

B-withhold the next dose. AN

C-Administer IV fluids
M
D-Repeat the blood lithium level testing
AH

EXPLANATION:
Lithium makes the kidneys less able to concentrate urine, so you produce more urine
R

and need to drink more water to keep up with the extra fluid loss. If you don't drink
enough to keep up with the high output, you can become dehydrated and develop
U

lithium toxicity -- high levels of lithium in the blood.

D

5- A client under lithium medication reduce his dietary salt intake. Which of the
following is expected to show in his blood work?
AB

A. Decreased lithium level

E/

B. Increased lithium level

M

C. Increased then decrease in the next result of the lithium blood work
T.

D. No significant changes

EXPLANATION:

There is a direct relationship between the amount of salt and the plasma levels of
lithium. Lithium plasma levels increase when there is a decrease in dietary salt.
Increase in dietary salt causes the opposite effect of decreasing lithium plasma.
 -acetyl cholinesterase inhibitor (often abbreviated AChEI) or anti-cholinesterase is a
chemical or a drug that inhibits the acetyl cholinesterase enzyme from breaking down
acetylcholine)‫ناقل عصبي‬,)

-acetyl cholinesterase inhibitors may be used in clients with Alzheimer's disease to

improve cognitive functions.

FI
-Medications to treat Alzheimer Disease:

AI
2-donepezil (Aricept)

An inhibitor of acetyl cholinesterase used to treat mild to moderate dementia of

LF
Alzheimer's disease.
Side effect nausea and diarrhea, bready cardia.

_A
3-Galantamine (Razadyne)

-An inhibitor of acetyl cholinesterase used to treat mild to moderate dementia of

Alzheimer's disease. AN
-Side effect nausea and diarrhea, bready cardia, can cause bronchoconstriction it
M
should be used with caution in client with asthma.
4-Memantine (namenda)
AH

N-methyl-D-aspartate (NMDA) receptor antagonist used to treat moderate to severe

dementia of Alzheimer's disease.
R

5-rivestagmine (Exelon)
U

-cholinesterase used to treat mild to moderate dementia of Alzheimer's disease.

D

-Side effect nausea, vomiting and diarrhea, bready cardia, can cause
AB

bronchoconstriction it should be used with caution in client with asthma.

6-Tacrine (cognex).
E/

-cholinesterase used to treat mild to moderate dementia of Alzheimer's disease.

M

-Side effect nausea and diarrhea, vomiting, increased liver function tests
T.

-General considerations for when and how to take Cognex include the following:

1-The medication comes in capsule form. It is usually taken by mouth four times
daily.

2-It is best to take Cognex on an empty stomach (between meals), since food can
decrease the absorption of the drug into the body.
 -Questions

1-Which of the following medications that treat Alzheimer's disease causes slowing of
the heart rate and fainting episodes?
A-tacrine(cognex).
B-galantamine (Razadyne)

FI
C-donepezile(Aricept).
D-all of the above.

AI
Explanation:

LF
Tacrine (Cognex), Galantamine (Razadyne), and Donepezil (Aricept) are anti-
Alzheimer drugs known to provoke slower heart rates and fainting episodes.

_A
2-Donepezil (Aricept) is prescribed for a client with Alzheimer's disease. The nurse
determines that the medication is having positive effects when what is observed?
a. Absence of wandering
b. Decreased progression of memory loss
c. Increase in "pin rolling"
d. Regaining the ability to drive a car
AN
M
Explanation:
AH

Rationale: Aricept is effective in the early stages of Alzheimer's disease. It might slow
or decrease progression of symptoms, but it will not reverse behaviors that are lost.

3-The lab results of a client treated for Alzheimer's disease reveals increased liver
R

function tests. The nurse recognizes that the drug most likely to cause this side effect
is:
U

a. Rivastigmine tartrate (Exelon).

D

b. Donepezil (Aricept).
c. Tacrine (Cognex).
AB

d. Galantamine (Reminyl).

Explanation:
E/

Rationale: Acetylcholinesterase inhibitors used for treatment of Alzheimer's disease

cause a variety of side effects. Elevated liver enzymes are specifically associated
With tacrine (Cognex) use.
M

4-A client with Alzheimer's disease has been receiving medication therapy for several
T.

months. The nurse should teach the client and caregiver to report signs of overdose,
which include:
a. Bradycardia and muscle weakness.
b. Tachycardia and hypertension.
c. Abdominal pain and dry mouth.
d. Emotional withdrawal and tachypnea.
 Explanation:
Rationale: An overdose of drugs to treat Alzheimer's disease could occur
if they are taken improperly, or if decreased liver or renal function occurs.
Symptoms of overdose include severe nausea/vomiting, sweating, salivation,
hypotension, bradycardia, convulsions, and muscle weakness, including respiratory
muscles.

FI
7-Antidepressants

AI
Are medications that can help relieve symptoms of depression, social anxiety

LF
disorder, anxiety disorders, seasonal affective disorder, and dysthymia, or mild
chronic depression,

_A
1-patient has depression and on antidepressants medication .while the nurse
caring him he asked (how long the medication takes to reach the effectiveness)
the proper nurse response is?

A- 3-4 days
AN
M
B- 10-4 days
AH

C- 14-18 days

D- A month
R

8-alcohol withdrawal
U
D

- signs and symptoms Anxiety Shaky hands ,Headache

,Nausea,Vomiting,Insomnia, Sweating.
AB

1-A male client is admitted to the substance abuse unit for alcohol detoxification.
Which of the following medications is Nurse Alice most likely to administer to reduce
E/

the symptoms of alcohol withdrawal?

A. Naloxone (Narcan)
M

B. Haloperidol (Haldol)
C. Magnesium sulfate
T.

D. Chlordiazepoxide (Librium)

Explanation:
Chlordiazepoxide (Librium) and other tranquilizers help reduce the symptoms of
alcohol withdrawal .Option A: Naloxone (Narcan) is administered for narcotic
overdose. Option B: Haloperidol (Haldol) may be given to treat clients with
psychosis. severe agitation. or delirium. Option C: Magnesium sulfate and other
anticonvulsant medications are only administered to treat seizures if they occur during
withdrawal.
 9-HEPARIN

-anticoagulant, used to prevent clot Enlargement.

-prolonged PTT.

-Report signs and symptoms of bleeding.

FI
-Monitor the client’s partial thromboplastin.

AI
-Keep protamine SO4 (antidote) at the bed side.

LF
-Unfractionated Heparin -Stop 4-6 hours before procedure

1-The patient receiving heparin therapy asks how the "blood thinner" works. The best

_A
response by the nurse would be:
1. "heparin makes the blood less thick"
2. "Heparin does not thin the blood but prevents clots from forming as easily in the
blood vessels" AN
3. "Heparin decreases the number of platelets so that blood clots more slowly"
4. "Heparin dissolves the clot"
M
2-PTT tests should be monitored while the clients is taking:
AH

A-cumadine.
C-heparin.
C-warfarin
R

D-non.
U

3-A client is taking low molecular heparin (enoxaparin) daily. Which client statement
requires additional monitoring?
D

a. "I take aspirin daily for headaches."

AB

b. "I take ibuprofen (Motrin) at least once a week for joint pain."
c. "Whenever I have a fever, I take acetaminophen (Tylenol)."
d. "I take my medicine first thing in the morning."
E/

4-A client who received heparin begins to bleed, and the physician calls for the
M

antidote. The nurse knows that which is the antidote for heparin?
T.

a. protamine sulfate
b. vitamin K
c. aminocaproic acid
d. vitamin C
 10-WARFARIN (COUMADIN)

-anticoagulant, used to prevent clot Enlargement.

-Report signs and symptoms of bleeding.

FI
-Monitor the client’s Prothrombin time.

AI
-Keep vitamin K (antidote) at the bed side.

LF
-Warfarin: Stop 6-7 days before procedure.

-Questions:

_A
1-PT tests should be monitored while the clients is taking.
A-dopamine
b-heparin.
c-warfarin
D-non.
AN
2-A client who received warfarin begins to bleed, and the physician calls for the antidote.
M
The nurse knows that which is the antidote for warfarin?
a. protamine sulfate
AH

b. vitamin K
c. aminocaproic acid
d. vitamin C
R

3-A client is started on warfarin (Coumadin) therapy while still receiving intravenous
U

heparin. The client questions the nurse about the risk for bleeding. How should the
nurse respond?
D

a. "Your concern is valid. I will call the doctor to discontinue the heparin."
b. "It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the
AB

heparin is continued until the warfarin is therapeutic."

c. "Because of your valve replacement, it is especially important for you to be
anticoagulated. The heparin and warfarin together are more effective than one
alone."
E/

d. "Because you are now up and walking, you have a higher risk of blood clots and
therefore need to be on both medications.
M

Explanation:
T.

"It usually takes about 3 days to achieve a therapeutic effect for warfarin, so the heparin is
continued until the warfarin is therapeutic.
 11-Plavix
Anti-platelet drugs such as clopidogerel are given to inhibit platelet aggregation and
thus reduce the risk of thrombus formation.

1-A patient has started clopidogrel (Plavix) after experiencing a TIA (transient

FI
ischemic attack). The desired therapeutic effects of this drug will be:
1. anti-inflammatory and antipyretic effects

AI
2. to reduce the risk of a stroke from a blood clot
3. Analgesic as well as clot-dissolving effects

LF
4. To stop clots from becoming emboli.

Explanation:

_A
Rationale: Anti platelet drugs such as clopidogerel are given to inhibit platelet
aggregation and thus reduce the risk of thrombus formation. Anti-platelet drugs do no
exert anti-inflammatory, antipyretic or analgesic effects. The anti-platelet and
AN
anticoagulant drugs do not prevent emboli formation. Thrombolytic dissolve existing
Blood clots.

12-ASA (ASPIRIN)
M
-Anti-inflammatory. Antipyretic, analgesic, anti-platelet aggregate.
AH

-Best Taken on full stomach.

R

-Assess the client for bleeding.

U

-contraindication in peptic ulcer disease.

D

-Questions
AB

1- A patient has taken an overdose of aspirin. Which of the following should a nurse
most closely monitor for during acute management of this patient?
E/

a-onset of pulmonary edema.

B-metabolic alkalosis
M

C-respiratory alkalosis
D-none.
T.

2-Which drug should be withheld for a child with suspected Reye syndrome?
A-aspirin.
B-calcium gluconatet.
C-atropine
D-none.
Explanation:
Reye's syndrome is most commonly associated with the over ingestion of aspirin.
 13-AZMACORT (TRIAMCINOLONE)

A-Corticosteroid, prevent asthma attack.

B-Ease of breathing

FI
C-Best taken with food or milk.

AI
-Questions

LF
1-A home care patient with chronic obstructive pulmonary disease (COPD) reports an
upset stomach. The patient is taking theophylline (Theo-Dur) and

_A
triamcinoloeacetonide (Azmacort) The nurse should instruct the patient to take:

A. Theo-dur an empty stomach

B. Theo-dur and azmacortat the same time

AN
M
C. Theo-dur and azmacort12 hours apart

D. Theo-dur milk or crackers.

AH

13-THEODUR (THEOPHYLLINE)
R

-Bronchodilator
U

-Easy breathing
D

-best taken in the morning to prevent insomnia

AB

-sign of toxicity include: vomiting, agitation .and tachycardia

E/

-Questions
3-The most common side effect of Theophylline /Aminophulline is:-
M

A-hypernatremia
b-hypotention.
T.

c-tachy cardia.(palpitation)
D-non.
 14-DIGOXIN (lANOXIN)

-cardiac glycoside increase force of cardiac contraction.

-Assess the client heart rate as it can cause bradycardia,

we should not administer dgoxin if HR is less than 60 and you should also check the
pulse for one full minute. Why is that when..diogoxin is to increase your Heart

FI
contracility..Why should it matter if HR is low?

AI
-the normal level of digoxin is between 0.5 and 2.0 nanograms

LF
-Assess for signs of toxicity (Nausea. Anorexia vomiting. Diarrhea).

-digoxin immune FAB (antidote).

_A
1-A newly admitted client takes digoxin 0.25 mg/day. The nurse knows that which is
the serum therapeutic range for digoxin?

a. 0.1 to 1.5 ng/mL

b. 0.5 to 2.0 ng/mL
AN
c. 1.0 to 2.5 ng/mL
M
d. 2.0 to 4.0 ng/mL
AH

2-The client is also taking a diuretic that decreases her potassium level. The nurse expects that
low potassium level (hypokalemia) could have what effect on the digoxin?
a. Increase the serum digoxin sensitivity level
R

b. Decrease the serum digoxin sensitivity level

c. Not have any effect on the serum digoxin sensitivity level
U

d. Cause a low average serum digoxin sensitivity level

D

3-The nurse reviews a client's laboratory values and finds a digoxin level of 10 ng/mL
and a serum potassium level of 5.9 mEq/L. What is the nurse's primary intervention?
AB

a. To administer atropine
b. To administer digoxin immune FAB
c. To administer epinephrine
E/

d. To administer Kayexalate

4-A two-year-old child with congestive heart failure has been receiving digoxin for
M

one week, what should a nurse do before giving medicine:

T.

A-check pulse for patient.

B-check temperature.
C-increase IV fluid with medication
Explanation:
Take pulse and notify the physician before taking medication if pulse rate is <60 or
>100.
 15-EPINEPHRINE

-Cardiac stimulant. Bronchodilator.

-Increase heart rate, easy breathing

-Assess for tachycardia.

FI
-Questions:

AI
1-A patient is given epinephrine (Adrenalin), an adrenergic agonist

LF
(sympathomimetic). The nurse should monitor the patient for which condition?

a. Decreased pulse

_A
b. Pupil constriction
c. Bronchial constriction
d. Increased blood pressure
AN
2-While caring for a patient who is experiencing a postoperative hemorrhage, the
healthcare provider notes the rhythm observed on the electrocardiogram (EKG) does
not produce a pulse. Which actions should the healthcare provider initiate to resolve
M
this patient’s problem?
AH

A-atropine.
B-adrenaline.
C-heparin.
R

D-morphine
U

16-ATROPINE:
D

-Injections of atropine are used in the treatment of bradycardia .

AB

- Atropine's actions on the parasympathetic nervous system inhibit salivary and mucus
glands. The drug may also inhibit sweating via the sympathetic nervous system.
E/

-Poisoning.
M

-Side effects of atropine include ventricular fibrillation, supraventricular or

ventricular tachycardia, dizziness, nausea, blurred vision, loss of balance, dilated
T.

pupils, photophobia, dry mouth, confusion, hallucinations .

 -Questions:

1- A group of patients came to emergency department after exposure to a chemical

material, what is the appropriate medicine that should be given to the patient:-
A-atropine.
B-adrenaline.
C-sodium nitrate.

FI
D-adenosine.

AI
EXPLANATION:
-atropine also serves as a treatment for poisoning by organophosphate insecticides

LF
and nerve gases, such as tabun (GA), sarin (GB), soman(GD).

_A
2-: What drugs are appropriate forms of treatment according to the Adult Bradycardia
with a Pulse Algorithm?
A-adrenaline.
AN
B-dopamine.
M
C-heparin.
D-atropine.
AH

EXPLANATION:
The correct dose of atropine in bradycardia is 0.5 mg given every 3 to 5 minutes to a
maximum dose of 3 mg. If the patient has poor perfusion, you administer atropine. If
R

atropine is ineffective, prepare for TCP or consider dopamine or epinephrine infusion.

U
D

3-Which medication acts as an antidote for pyridostigmine (Mestinon) toxicity?

AB

A-Atropine sulfate (Isopto Atropine).

b-Neostigmine (Prostigmin)
c-Edrophonium (Tensilon)
E/

d-Azathioprine (Imuran)
M

EXPLANATION:
T.

Overdose of pyridostigmine (Mestinon) causes cholinergic crisis. Atropine sulfate

(Isopto Atropine) acts as an antidote for pyridostigmine (Mestinon) bydecreasing
acetylcholine. Neostigmine (Prostigmin) is administered to manage myasthenia gravis.
Azathioprine (Imuran) is an immunosuppressant that is used to suppress immune
reactions. Edrophonium (Tensilon) is an acetylcholinesterase inhibitor that is used in
the diagnosis of myasthenia gravis.
 17-LASIX (FUROSEMIDE)

A-Diuretic.

B-increase urine output.

C-monitor serum potassium levels, it can cause hypokalemia.

D-Eat bananas and citrus fruits because they are good sources of potassium.

FI
-Questions

AI
1-The nurse acknowledges that which condition could occur when taking furosemide:

LF
a. Hypokalemia
b. Hyperkalemia

_A
c. Hypoglycemia
d. Hypermagnesemia

Mohammad Sami-0569945982
AN
M
2-The nurse is assessing a client who is taking furosemide (Lasix). The client's
potassium level is 3.4 mEq/L, chloride is 90 mmol/L, and sodium is 140 mEq/L. What
AH

is the nurse's primary intervention?

a. Mix 40 mEq of potassium in 250 mL D5W and infuse rapidly.

R

b. Administer Kayexalate.
c. Administer 2 mEq potassium chloride per kilogram per day IV.
U

d. Administer PhosLo, two tablets three times per day.

D

3- All is correct regarding Nexium except for

AB

a-Used to treat GERD..

b-Do not chew.
c-Should not be taken with other antacids.
E/

d- May be taken with other antacids.

18-ALDACTONE (Spironolactone)
M

-Spironolactone belongs to the class of medications known as diuretics

T.

-It is used to treat edema (fluid retention) that occurs with congestive heart failure,
cirrhosis of the liver, and nephrotic syndrome. It is also used to treat high blood
pressure and to diagnose and treat primary hyperaldosteronism.

- can also be used to treat or prevent hypokalemia.

 -Questions:-

1-What is the best information for the nurse to provide to the client who is receiving
spironolactone (Aldactone) and furosemide (Lasix) therapy:

FI
a. "Moderate doses of two different diuretics are more effective than a large dose of
one."

AI
b. "This combination promotes diuresis but decreases the risk of hypokalemia."
c. "This combination prevents dehydration and hypovolemia."
d. "Using two drugs increases the osmolality of plasma and the glomerular filtration

LF
rate."

2-The client has been receiving spironolactone (Aldactone) 50 mg/day for heart

_A
failure. The nurse should closely monitor the client for which condition?

a. Hypokalemia
b. Hyperkalemia
c. Hypoglycemia
AN
d. Hypermagnesemia
M
19-MANNITOL
AH

A-Diuretic, used to treat cerebral edema

R

B-increased urine output

U

C-monitor BP and serum potassium levels

D

1-Which client would the nurse need to assess first if the client is receiving mannitol
(Osmitrol)?
AB

a. A 67-year-old client with type 1 diabetes mellitus

b. A 21-year-old client with a head injury
E/

c. A 47-year-old client with anuria

d. A 55-year-old client receiving cisplatin to treat ovarian cancer.
M

EXPLANATION:
T.

Mannitol (Osmitrol) is not metabolized but excreted unchanged by the kidneys.

Potential water intoxication could occur if mannitol is given to a patient with anuria.
Mannitol is safe to use with diabetic patients and those with head injuries, and it may
function as a nephroprotectant when cisplatin is being used.
 2-Which assessment indicates a therapeutic effect of mannitol (Osmitrol)?

a. Decreased intracranial pressure

b. Decreased potassium
c. Increased urine osmolality
d. Decreased serum osmolality

FI
3-A nurse is caring for a 30year-old comatose patient who was admitted with subdural
hematoma. Intravenous mannitol was given to the patient. What the nurse should

AI
notice if mannitol was used for a long term?

LF
A. Hyperthermia

B. Puplis non-reactive

_A
C. Urine output decrease

D. Increased blood pressure.

20-QUINIDINE
AN
M
A-Ant arrhythmias
AH

B-side effect:-hypotension, bradycardia, diarrhea.

C-Avoid drinking grapefruit with this drug.

R

21-MORPHINE SULFATE
U

-Narcotic agonist.
D
AB

-Relief of pain) severe pain)

-Avoid driving .report severe nausea and vomiting.

E/

-Keep naloxone HCL (Antidote) at the bed side.

M

-Common morphine side-effects

T.

-Feeling sick (nausea) or being sick (vomiting)

-Shallow breathing you should not take morphine

If you have severe asthma or breathing problems,

-Constipation., stomach pain

-Hypotension. Feeling dizzy, sleepy or drowsy

 -Questions:

1-When caring for a patient who is receiving morphine it is most important that the
nurse regularly assess for which of the following?
A. respiratory depression
B. hyperactive bowel sounds
C. frequent urination

FI
D. insomnia

AI
-Explanation

LF
-A. The nurse should recognize that airway, breathing, and circulation (ABCs) are
priority considerations. Respiratory depression is the most important adverse effect
to observe for in people taking an opioid such as morphine. Additionally,

_A
it is necessary to assess patients taking morphine for the presence of hypotension.
Bowel sounds are likely to be hypoactive rather than hyperactive, urination
is likely to be less frequent, and sleep is more likely than insomnia.

AN
2-A man is difficult to arouse after IV administration of morphine sulfate. He has a
respiratory rate of 7 breaths/min. The nurse should IMMEDIATELY administer:
M
A. phenytoin (Dilantin)
B. tramadol (Ultram)
AH

C. naloxone (Narcan)
D. atropine sulfate (Atropine)
R

-Explanation
U

. Naloxone is an opioid antagonist. It counteracts the overdose.

D

3-A home care nurse visits an elderly patient who had a surgical repair for fracture.
AB

The patient is taking morphine. Today, the patient complaints of decreased appetite
and absence of a bowel movement for 3days. Which of the following can be inferred?
E/

A- Decreased appetite due to depression.

B-Constipation related to use of opioids.
M

C- Constipation due to acute pain.

D. none.
T.
 22-VALIUM (DIAZEPAM)

-muscle relaxant

-decreased anxiety, adequate sleep.

-Best taken before meals

FI
-antidote for valium.

AI
1-A patient is admitted to the emergency department with status epileptics. Which drug

LF
should the nurse most likely prepare to administer to this patient? (Select all that apply.)

a. diazepam (Valium)

_A
b. gabapentin (Neurontin)
c. levetiracetam (Keppra)
d-non.

23-Phenytoin:
AN
-is an anti-epileptic drug, also called an anticonvulsant.
M
1-The nurse should monitor the patient receiving phenytoin for which adverse effect?
AH

a. Psychosis.
b. Nosebleeds.
c. Hypertension.
R

d. Gum erosion.
U

EXPLANATION:
D

Nosebleed is found among people who take Phenytoin, especially for people who are
female, 2-9 old, have been taking the drug for < 1 month, also take medication
AB

Lamotrigine, and have Convulsion.

24-ADENOSINE:-
E/

-Indication: stable narrow complex SVT

M

-Adenosine may cause bronchospasm; therefore, adenosine should generally not be

given to patients with asthma or chronic obstructive pulmonary disease.
T.

Route: IV rapid push

Dosage: 6 mg follow by a 20mL of NS raise extremity, second dosage of 12 mg if

needed, 1-2min.
 -Questions:

1-Which drug is the preferred intervention for terminating narrow-complex

tachycardias that are symptomatic (but stable) and supraventricular in origin (SVT)?
A-atropine.
B-adrenaline
c-corderone.

FI
d-adenosine.

AI
-EXPLANATION:
Vagal maneuvers and Adenosine are the preferred intervention for terminating

LF
narrow-complex tachycardias that are symptomatic (but stable) and supraventricular
in origin (SVT).

_A
25-NITROGLYCERINE
-Indication: hypertensive urgency with ACS
-Precaution: hypotension AN
1-A patient came to emergency department, complaints of angina. Nitroglycerin
M
(Nitrate) ordered the physician. This medication is to be administered via which of the
following routes?
AH

A- Intradermal.
B-Buccal. Or sublingual.
R

C- Parental.
D-Topical.
U

26-Folic Acid:-
D

-Folic acid is a man-made form of a B vitamin called folate.

AB

-Birth defects occur within the first 3-4 weeks of pregnancy. So it's important to have
folate in your system during those early stages when your baby's brain and spinal cord are
E/

developing.
M

-Folic acid is a pregnancy superhero! Taking a prenatal vitamin with the recommended
400 micrograms (mcg) of folic acid before and during pregnancy can help prevent birth
T.

defects of your baby's brain and spinal cord.

-Folic acid dose during pregnancy:-400 micrograms.
Levodopa is one of the main drugs used to treat Parkinson's symptoms. It can be
used at all stages of the condition.
 27-acetaminophen (Tylenol®)

- belongs to a class of drugs called analgesics (pain relievers) and antipyretics (fever
reducers).
-is NOT an NSAID and is therefore the preferred non-prescription treatment for pain
in patients at risk for peptic ulcer disease.

FI
-Questions.

AI
1-Which of the following medications are preferred used in peptic ulcer disease:
A-aspirin.

LF
B- Acetaminophen.
C-heparin.
d-A and B.

_A
-anthrax treatment:
AN
M
AH
R
U
D
AB
E/
M

28-Isoniazid
T.

-Isoniazid is an antibiotic. It prevents tuberculous bacteria from multiplying in the

body.

-Isoniazid is used to treat and to prevent tuberculosis (TB).

-An acute viral hepatitis-like syndrome arising 6 weeks after starting therapy is typical
of isoniazid hepatitis.
 29-Corticosteroid:-

Corticosteroid drugs — including cortisone, hydrocortisone and prednisone —

are useful in treating many conditions, such as rashes, lupus and
asthma,nephrotic syndrome.

1-The nurse is providing care for a patient who has been admitted to the hospital for

FI
the treatment of nephrotic syndrome. Which of the following drug of choice for patient
with nephrotic syndrome:-

AI
A-prednisone (corticosteroids)
B-NSAIDs

LF
C-ibuprofen
D-none of the above.

_A
30-Nexium
Is used to treat certain stomach and esophagus problems (such as acid reflux, ulcers). It
AN
works by decreasing the amount of acid your stomach makes. It relieves symptoms such
as heartburn, difficulty swallowing, and persistent cough. This medication helps heal acid
damage to the stomach and esophagus, helps prevent ulcers, and may help
M
prevent cancer of the esophagus. nexium belongs to a class of drugs known as proton
pump inhibitors (PPIs).
AH

Take this medication by mouth as directed by your doctor, usually once daily, at least 30
minutes to 1 hour before a meal.
R
U
D
AB
E/
M
T.

31-PETHEDINE (mepridene).

-A narcotic analgesic that can be used for the relief of most types of moderate to
severe pain, including postoperative pain and the pain of labor.

-Acute rheumatic fever------ Bezathgine penicillin (Megacillin)

 32-Oxytocin:-
Oxytocin, sold under the brand name Pitocin among others, is a medication made
from the peptide oxytocin ,As a medication, it is used to cause contraction of the
uterus to start labor, increase the speed of labor, and to stop bleeding following
delivery

FI
1-A 40 week pregnant client is going to have their labor induced. Which of the
following medication would the nurse anticipate to give to the client?

AI
A-olanzapin

LF
B-omeprazole

_A
C-oxycodone

D-oxytocin

Collection questions:-
AN
M
1-A nurse is leading an educational session on the correct use of oral contraceptives.
One of the attendees ask the nurse what to do if she missed taking an oral
contraceptive for one day? Which of the following should be the nurse advice to her?
AH

A. Continue as usual with no back up contraception

B. Take an active pill immediately and take the next pill at
R

The usual time

U

C. Take two pills as soon as possible and then one pill daily
D

At the usual time

AB

D. Use back up contraception such as a condom for the

E/

Next 7 days.

2- Clomiphene citrate (Clomid) is prescribed for a 32-year-old infertility treatment the

M

nurse should understand that this medication is used for following actions?
T.

A. Induce ovulation

B. Decrease prolactin level

C. Reduce endometriosis

D. Stimulate the release of Follicle-Stimulating Hormone

 3-a nurse is caring for a patient who had Coronary Artery bypass Graft Surgery
(CABG) four hours ago. The nurse notices that the patient has increased confusion
and is restless. The patient reports nausea, weakness and paresthesia in the extremities
(see lab results)

Test Result Normal Values

Sodium 145 134-146 mmol/L

FI
Potassium 6.8 3.5-5.2 mmol/L

AI
Calcium 2.50 2.15-2.62 mmol/L

Which of the following is the best medication?

LF
A. Naloxone (Narcan)

_A
B. Hydralazine (Apresoline)

C. Potassium chloride (KCI)

D. Sodium polystyrene sulfonate (Kayexalate)

AN
M
4-A nurse in the Neonatal Intensive Care Unit is caring for premature newborn, is
diagnosed with Respiratory Distress (RDS) and the doctor ordered administrating
AH

surfactant should be given by which of the following routes?

A. Intravenous
R

B. Subcutaneous
U

C. Intramuscular
D

D. Endotracheal
AB

5-What is the contraindication of oral contraceptive bills

E/

A- Thrombophlebitis
M

6-A patient with bipolar disorder taking lithium , he complains diarrhea ,slight tremor
in left hand and slurring pattern to his speech, which of the following nursing priority
T.

for this patient :-

A-monitor lithium level.

T.
M
E/
AB
D
U
R
AH
M
AN
_A
LF
AI
FI