Patient 1
John Steven
age 81 Sex M Height 5'9'' Weight 150 lb
Allergies NKA
Race Black
Diagnosis
Primary 1. Chronic renal failure
2. Dementia
Secondary 1. Anemia
Lab
Date Test Date Test
1. 5/4 BUN 75 mg/dl 5. 5/4 Hgb 7.8 g/dl
2. 5/4 Creatinine 6.0 mg/dl 6. 5/4 Phosphate 7.6 mg/dl
3. 5/4 Potassium 7.5 mEq/L 7. 5/7 Potassium 7.5 mEq/L
4. 5/4 HCT 24%
Medication order including Parenteral Solutions
Date Route Sig
1. 5/4 Mylanta 30 ml po prn
2. 5/4 Kayexalate 30 g po qid prn
3. 5/4 Calcitriol 1 mg po i qd
4. 5/4 Calcium carbonate 1 g po ii qid
5. 5/4 Colace 100 mg po bid
6. 5/7 Haloperidol 1 mg po bid
7. 5/9 Amphojel 30 ml po qid pc
8. 5/9 Ferrous sulfate 300 mg po qid pc
Dietary Consideration Enteral and Parenteral
Date Comments
1. 5/4 Protein-restricted diet
Pharmacist Note and Other Patient Information
Date Comments
1. 5/9 D/C Mylanta
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Questions
1. Which mechanism describe how Ampho jel achieves its therapeutic effect in Mr.Steven?
A.Potasium binding
B. Phosphate binding
C. Acid neutralizing
D. Base neutralizing
E. ion exchange
2. Kayexalate achieves its therapeutic effect by acting as an exchange resin. Which ion is exchanged with sodium?
A. Potassium
B.Phosphorus
C. Calcium
D.Nitrogen
E. Magnesium
3. Which type of anemia is most likely to occur in chronic renal failure?
A. Normachromic, normocytic
B. Hypochromic, nomocytic
C. Hypochromic, microcytic
D. Normochromic, macrocytic
E. Hypochromic, macrocytic
4. Which medication(s) would need a dosage reduction in renal failure?
I. Haloperidol
II. Digoxin
III. Tobramycin
A. I only
B. III only
C. I and II
D. II and III
E. I, II and III
5. Calcitriol is the same substance as:
A. Calcium carbonate
B. Calcium gluconate
C. 1, 25- dihydrocholecalciferol
D. Calcium leucovorin
E. Dihydrotachysterol
6. Which drugs in the patient's therapeutics regimen are likely to cause constipation?
I. Amphojel
II. Kayexalate
III. Calcitriol
A. I only
B. III only
C. I and II
D. II and III
E. I, II and III
7. Life-threatening cardiac arrhythmias due to hyperkalemia should be treated with:
I. Calcium chloride or calcium gluconate intracenuously
II. Loop diuretic
III. Sodium polystyrene sulfonate
A. I only
B. III only
C. I and II
D. II and III
E. I, II amd III
8. Which adverse effect of haloperidol is most likely to occur in Mr. Stevens?
A. Neuroleptic malinant syndrome
B. Extrapyramidal symptoms
C. Urinary retention
D. Cardiovascular effects
E. Decreased seizure threshold
9. When Mr. Stevens complained of gastrointestinal discomfort, the physician prescribed cimetidine. The nurse should be altered that cimetidine interacts with:
I. Amphojel
II. Colace
III. Ferrous sulfate
A. I only
B. III only
C. I and II
D. II and III
E. I. II and III
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Answer: Hide by yellow letter
1. B
2. A
3. A
4. D
5. C
6. C
7. A
8. B
9. A
Alan H. Mutnick, Paul F. Souney. et al. Comprehensive Pharmacy Review Fifth Edition Practice Exams. Lippincott Williams & Wilkins.2004.
