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Questions,Answers and explanations
2023 - 2024 |Graded A+
Pharmacology Final Test Bank 194
Questions,Answers and explanations
A 28-year-old patient has been prescribed penicillin for the first time. What nursing diagnosis would be most appropriate for this patient? A. Acute pain related to gastrointestinal (GI) effects of the drug B. Deficient knowledge regarding drug therapy C. Imbalance nutrition: less than body requirements related to multiple GI effects of the drug D. Constipation - ✔️ B. Because this is the first time the patient has taken penicillin, she is likely to have limited knowledge about the drug. She may not understand the importance of taking the medication as ordered to increase effectiveness of the drug or to report adverse effects. because the patient has not started the drug yet, there is no way to know what adverse effects, if any, she will experience. Only if she develops acute pain related to GI effects of the drug would this be appropriate. If GI symptoms develop it may lead to imbalanced nutrition, but that remains to be seen. No indication about constipation exists.
he mother of a 5-year-old asks the nurse why it seems amoxicillin is always prescribed when her child needs an antibiotic. What is the priority rationale the nurse should give the mother? A) It is better absorbed. B) It is less costly. C) It has a less frequent dosing schedule. D) It tastes better in oral form. - ✔️ Ans: A Feedback: Most penicillins are rapidly absorbed from the GI tract, reaching peak levels in 1 hour. Although amoxicillin is less expensive, that fact has far less impact on choosing the proper antibiotic than the effectiveness of the drug. Most oral antibiotics for children are available in pleasant tasting syrups so taste would not be a factor. Ampicillin is often given up to 4 times a day so it actually has a frequent dosing schedule.
- The nurse is teaching the patient about amoxicillin prior to discharge and includes what important teaching point? A) Blackening of the tongue may occur but will subside when the drug is discontinued. B) Even if it seems like the infection is not improving, the drug is still working.
Questions,Answers and explanations
2023 - 2024 |Graded A+
C) Yeast infections are unlikely to occur with this medication because it is narrow spectrum. D) Appearance of a rash is common and does not indicate an allergic reaction. - ✔️ Ans: A Feedback: One of the adverse effects of ampicillin is blackening of the tongue but the discoloration goes away after stopping the drug. If it is accompanied by swelling, the patient should be instructed to call the prescribing health care provider immediately. Many penicillin-resistant pathogens exist, so if the infection does not seem to be responding to the drug, the patient should notify the health care provider because a different antibiotic may be required. Yeast infections are very likely after taking ampicillin because it is a broad-spectrum antibiotic. Appearance of a rash should be evaluated by a health care professional because allergic reactions to this class of antibiotic are very common.
A local bioterrorism medical team is learning about germ warfare. The team is instructed that a fluoroquinolone may be used to prevent an outbreak of anthrax infection. What fluoroquinolone would the nurse be most likely to administer for this purpose? A) Ciprofloxacin (Cipro) B) Gemifloxacin (Factive) C) Norfloxacin (Noroxin) D) Sparfloxacin (Zagam) - ✔️ Ans: A Feedback: Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and is indicated for the prevention of anthrax infection. Gemifloxacin and sparfloxacin are most useful in treating acute episodes of chronic bronchitis and community-acquired pneumonia. Norfloxacin is recommended only for certain types of urinary tract infections.
The nurse is providing patient teaching before discharging a patient home. The patient is taking ciprofloxacin (Cipro). What would the nurse teach this patient is the best way to prevent crystalluria caused by ciprofloxacin (Cipro)? A. Eliminate red meat and seafood from the diet. B. Encourage at least 2 liters of fluid per day. C. Avoid caffeine and alcohol. D. Spend time in the sun each day to optimize vitamin D levels. - ✔️ B. Encourage at least 2 L of fluid per day Provide the following patient teaching: Avoid driving or operating dangerous machinery because dizziness, lethargy, and ataxia may occur; try to drink a lot of fluids and maintain nutrition (very important), even though nausea, vomiting, and diarrhea may occur. There is no need to eliminate red meat, seafood, caffeine, or alcohol from the diet, although alcohol may increase the risk of GI irritation. Patients should be taught to avoid the sun due to possible photosensitivity.
Questions,Answers and explanations
2023 - 2024 |Graded A+
The nurse would question whether the child was ever given tetracycline because this drug is commonly associated with discoloration of secondary teeth when it is administered to children who still have their primary teeth. Gentamicin, ampicillin, and cephalexin are not associated with discoloration of the teeth.
The clinic nurse is providing health teaching to a patient who has been prescribed doxycycline (Doxycin). What is a priority teaching point for this patient? A) Stay out of the sun. B) Avoid sexual activity. C) Take an antacid with the drug if nausea occurs. D) Chew the tablets completely before swallowing. - ✔️ ANS: A
Encourage the patient to apply sunscreen and wear protective clothing if sun exposure cannot be avoided to protect exposed skin from rashes and sunburn associated with photosensitivity reactions. If the patient is a woman the nurse may advise the patient to use barrier methods of contraceptives (if she is taking oral contraceptives) due to the drugdrug interaction but the patient would not be told to avoid sexual activity. Antacid therapy and chewing the tablets would be inaccurate information.
A 78-year-old woman, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient's medication, the nurse discovers that the patient is taking Azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient? A) The half-life of the drug is 3 to 7 hours. B) It is taken only once a day. C) It has very few adverse effects. D) It can be given without consideration to drugdrug interactions. - ✔️ ANS: B
A mother brings her 3-year-old child to the emergency department telling the nurse the child has eaten a bottle of baby aspirin. The mother cannot tell the nurse how many tablets were in the bottle. What dose of salicylate would be toxic in a child? A) 2g B) 3g C) 4g D) 5g - ✔️ ANS: C
A patient arrives at the emergency department brought by his or her friends. The friends tell the nurse that the patient has taken a whole bottle of aspirin. Blood work for salicylate toxicity is run. What does the nurse expect the results to be? A) >5 g B) >10 g
Questions,Answers and explanations
2023 - 2024 |Graded A+
C) >15 g D) >20 g - ✔️ ANS: D
Antipyretic drugs (e.g., aspirin, ibuprofen, acetaminophen) often are used to alleviate the discomforts of fever and to protect vulnerable organs, such as the brain, from extreme elevations in body temperature. However, the use of aspirin in children is limited due to the possibility of what disease? A) Munchausen's syndrome B) Guillain-Barré syndrome C) Angelman's syndrome D) Reye's syndrome - ✔️ AND: D
A patient presents at the emergency department complaining of dizziness, mental confusion, and difficulty hearing. What should the nurse suspect is wrong with the patient? A) Anakinra toxicity B) Ibuprofen toxicity C) Salicylism D) Acetaminophen toxicity - ✔️ ANS: C
The nurse is caring for a patient who reports taking 800 mg of ibuprofen three times a day for relief of menstrual cramps. What lab results will the nurse find most significant in assessing this patient? A) Complete blood count B) White blood cell differential C) Arterial blood gas D) Cholesterol and triglyceride profile - ✔️ ANS: A
When nonsteroidal anti-inflammatory drugs (NSAIDs) are combined with loop diuretics, there is a potential for what? A) Decreased antihypertensive effect B) Decreased diuretic effect C) Lithium toxicity D) Anaphylactoid reactions - ✔️ ANS: B
A nurse is presenting an educational event for a group of new parents. One topic that the nurse addresses is the overuse of acetaminophen, which can cause liver toxicity. What would the nurse tell the parents it is important to do? A) Do not give acetaminophen (Tylenol) unless you receive a doctor's order.
Questions,Answers and explanations
2023 - 2024 |Graded A+
D. Fluvoxamine - ✔️ ANS: A
The patient has been severely depressed since her father died 6 months ago. The physician has prescribed amitriptyline. The nurse reviews the patient's chart before administering the medication. What preexisting condition would require cautious use of this drug? A) Osteosarcoma B) Cardiovascular disorders C) Closed head injury D) Bleeding ulcer - ✔️ ANS: B
The nurse is caring for a patient who is taking amitriptyline for depression. What teaching will the nurse include in the teaching plan to help the patient monitor for adverse effects? A) If chest pain occurs an over-the-counter pain reliever will help. B) Nasal congestion indicates a respiratory virus is beginning. C) Measure and record your blood pressure daily. D) Adverse effects will subside as you adjust to the medication. - ✔️ ANS: C
A patient with severe depression has been hospitalized and the physician has ordered amitriptyline. What common adverse effect will the nurse monitor and assess the patient for? (Select all that apply.) A) Fever B) Myocardial Infarction C) Stroke D) Dry mouth E) Gynecomastia - ✔️ ANS: B, C, D
A patient comes to the mental health clinic for a regular appointment. The patient tells the nurse he has been taking oral fluoxetine (Prozac) 20 mg daily for the past 3 weeks and that he has lost 3 pounds during that time due to a loss of appetite. What action should the nurse take? A) Teaching the patient about healthy eating to maintain weight B) Congratulating the patient on his weight loss and commenting how well he looks C) Encouraging the patient to increase fluid intake to avoid further weight loss D) Reassuring the patient that a decrease in weight is a common adverse effect with this medication - ✔️ ANS: D
A patient has been taking Prozac (fluoxetine) for the past 3 years for depression. She is seeing her gynecologist for premenopausal symptoms and during the
Questions,Answers and explanations
2023 - 2024 |Graded A+
interview with the nurse she says that she would like to try Sarafem because her friend is taking it and she says it works great. The nurse's best response is what? A) Sarafem and Prozac are different brand names for the same generic medication. B) Before changing drugs it is important to consider how well you responded to Prozac. C) You cannot take both drugs at the same time so it will be important to decide which is best. D) When taking both of these drugs, it is best to take one in the morning and one at night. - ✔️ ANS: A
The nurse evaluates the patient's serum phenytoin (Dilantin) level and determines the level is therapeutic when it is within what range? A) Between 5 and 12 mcg/mL B) Between 10 and 20 mcg/mL C) Between 15 and 50 mcg/mL D) Between 40 and 100 mcg/mL - ✔️ ANS: B
A nurse is teaching a patient about his or her newly prescribed drug, phenytoin (Dilantin) for a seizure disorder. What will the nurse alert the patient to as a serious adverse effect of this drug? A) Drowsiness B) Fatigue C) Rash D) Lethargy - ✔️ ANS: C
An 8-year-old child has been diagnosed with a seizure disorder and phenytoin (Dilantin) has been prescribed for him or her. What nursing diagnosis would be appropriate if the child demonstrated adverse effects to the drug? A) Deficient fluid volume B) Impaired skin integrity related to dermatological effects C) Noncompliance for drug therapy D) Sleep deprivation - ✔️ ANS: B
A patient is admitted to the emergency department with severe recurrent convulsive seizures. What drug would the nurse expect to be ordered for use in emergency control of status epilepticus? A) Phenytoin (Dilantin) B) Diazepam (Valium) C) Phenobarbital (Luminal) D) Ethosuximide (Zarontin) - ✔️ ANS: C
Questions,Answers and explanations
2023 - 2024 |Graded A+
B. Clorazepate (Tranxene) C. Felbamate (Felbatol) D. Gabapentin (Neurontin) - ✔️ ANS: A
A 20-year-old female patient has been diagnosed with multiple sclerosis. What drug will most likely be prescribed? A) Baclofen (Lioresal) B) Cyclobenzaprine (Flexeril) C) Metaxalone (Skelaxin) D) Orphenadrine (Banflex) - ✔️ ANS: A
The nurse is caring for a patient who is being discharged home from the rehabilitation unit. Baclofen will be discontinued and the patient will begin taking carisoprodol as an outpatient. What is the nurse's primary consideration about discontinuing administration of baclofen? A) Taper drug over 72 hours to reduce dependence on the drug. B) Alternate doses of baclofen and soma over 10 days to prevent drug withdrawal. C) Taper drug slowly over 1 to 2 weeks to prevent psychoses and hallucinations. D) Start carisoprodol immediately while continuing baclofen at full dose to establish carisoprodol level. - ✔️ ANS: C
The nurse is caring for a patient receiving intrathecal baclofen via pump while participating in rigorous rehabilitation therapy. What is the nurse's priority to monitor related to adverse effects of this drug? A) Blood pressure B) Pulse pressure C) Spasticity D) Respiratory status - ✔️ ANS: D
A patient is admitted to the unit with central spasticity after a terrible motor vehicle accident. The doctor places an intrathecal delivery pump. What medication can be administered via this route to treat the central spasticity? A) Baclofen (Lioresal) B) Cyclobenzaprine (Flexeril) C) Dantrolene (Dantrium) D) Carisoprodol (Soma) - ✔️ ANS: A
Baclofen is a prototype drug for the centrally acting skeletal muscle relaxants. What adverse effects do drugs in this class have? (Select all that apply.) A) Coronary artery disease
Questions,Answers and explanations
2023 - 2024 |Graded A+
B) Hypotension C) Urinary frequency D) Dizziness E) Bone marrow suppression - ✔️ ANS: B, C, D
The nurse is caring for a patient who is having a pump placed to deliver intrathecal baclofen and another patient who will receive dantrolene as a muscle relaxant. What nursing diagnosis would be appropriate for both care plans? (Select all that apply.) A) Acute pain related to GI effects of drug B) Risk for injury related to central nervous system (CNS) effects C) Disturbed body image related to muscle pain D) Disturbed thought processes related to CNS effects E) Deficient knowledge related to procedure - ✔️ ANS: A, B, D
When caring for a patient taking dantrolene, what adverse effects would the nurse monitor for? (Select all that apply.) A) Bradycardia B) Hepatitis C) Urinary retention D) Fatigue E) Rash - ✔️ ANS: B, D, E
A patient with severe spasticity sees his physician. The physician orders dantrolene. In what circumstances is the drug dantrolene contraindicated? A) Spasticity that contributes to upright position B) Spasticity that involves both legs C) Spasticity that involves the arm and the leg on the same side D) Spasticity that contributes to mobility - ✔️ ANS: A
A patient has been diagnosed with multiple sclerosis and experiences spasticity in several muscle groups. What drug would the nurse anticipate will be ordered as the drug of choice to manage spasticity associated with neuromuscular diseases? A) Dantrolene (Dantrium) B) Baclofen (Lioresal) C) Carisoprodol (Soma) D) Botulinum toxin type B (Myobloc) - ✔️ ANS: A
The nurse is caring for a patient taking dantrolene. How would the nurse assess the therapeutic effects of this drug?
Questions,Answers and explanations
2023 - 2024 |Graded A+
D) 2 mL - ✔️ ANS: A
The patient in labor receives morphine every 2 hours to manage labor pain. After 22 hours of labor the woman delivers a baby boy. What is the nurse's priority action related to the newborn? A) Monitor for opioid effects. B) Administer naloxone. C) Monitor for withdrawal syndrome. D) Assess for congenital anomaly. - ✔️ ANS: A
A nurse is caring for a 6-year-old patient after surgery. The child has an order for meperidine (Demerol) 1.8 mg/kg IM every 3 to 4 hour as needed for pain. The child weighs 30 kg and the meperidine is available as 50 mg/mL. How many mL will the nurse administer per dose? A. 1 mL B. 1.8 mL C. 0.8 mL D. 1.08 mL - ✔️ ANS: D
The health care provider orders oral (PO) codeine as an adjunctive therapy to pain control medication. What order would be appropriate for the nurse to administer? A) Codeine 5 mg PO every 6 hour B) Codeine 10 mg PO every 4 hour C) Codeine 15 mg PO every 2 hour D) Codeine 20 mg PO every 4 hour - ✔️ ANS: D
What drug might the nurse administer for both analgesic and antitussive effects? A) Codeine B) Aspirin C) Ibuprofen D) Acetaminophen - ✔️ ANS: A
Before administering an ergot drug to the patient for the first time, the nurse would assess the patient's currently prescribed medications for what drug? A) Antidiabetic agents B) Beta adrenergic blockers C) Oral contraceptives D) Selective serotonin reuptake inhibitors (SSRIs) - ✔️ ANS: B
Questions,Answers and explanations
2023 - 2024 |Graded A+
A patient with migraine headaches is changed from an ergot to a prescription for a triptan. The nurse has completed teaching related to the drug. What statement would indicate she has a clear understanding of the new drug? A) My life is over. I can't function not knowing when I'm going to have a headache. B) I will not have to avoid driving because this medication isn't sedating. C) I should not experience as many adverse effects from my new medication. D) I take my medication every hour when I have a headache. - ✔️ ANS: C
The nurse receives an order for a triptan for a patient diagnosed with cluster headaches. What drug would be indicated for this purpose? A) Almotriptan (Axert) B) Frovatriptan (Frova) C) Naratriptan (Amerge) D) Sumatriptan (Imitrex) - ✔️ ANS: D
The nursing instructor asks the student nurse to explain the action of sumatriptan. What is the student's best response? A) Vasoconstrictive on cranial blood vessels B) Depresses pain response in the central nervous system C) Vasodilation of peripheral blood vessels D) Binds to acetylcholine receptors to prevent nerve transmission - ✔️ ANS: A
The nurse receives a patient into the postanaesthesia care unit who has had surgery using the anesthetic agent methohexital. The nurse anticipates the patient's need for what in the postoperative period? A) Assistance in maintaining respirations B) Assistance in moving lower extremities C) Positioning in Semi-Fowler's position D) Analgesia to control the patient's pain - ✔️ ANS: D
The patient received midazolam in combination with an inhaled anesthetic and a narcotic during surgery. The postanesthesia care unit (PACU) nurse anticipates this combination of drugs will have what impact on the patient's stay in the unit? A) Increased use of medications to offset adverse effects B) Extended time needed in the unit C) Decreased nursing support needed D) Increased analgesics needed - ✔️ ANS: B
A nursing student in a pharmacology class asks the instructor why nitrous oxide is used for dental surgery. What is the instructor's most accurate response?
Questions,Answers and explanations
2023 - 2024 |Graded A+
C) Procaine is an amide that is broken down immediately in the tissues. D) Procaine is metabolized by the liver with risk of toxicity and is classified as an ester. - ✔️ ANS: A
The patient receives lidocaine as a local anesthetic before insertion of a chest tube. After the procedure the patient tells the nurse, The area is still numb. How long will this last? What is the nurse's best response? A) 15 minutes B) 1 hour C) 2 hours D) 4 hours - ✔️ ANS: C
The nurse is collecting a nursing history from a preoperative patient who is to receive local anesthesia. While taking the admission history, the patient says she is allergic to lidocaine. What is the nurse's priority action? A) Notify the anesthesiologist. B) Cancel the surgery. C) Notify the surgeon. D) Tell the perioperative nurse. - ✔️ ANS: A
What medication, if ordered for an 8-year-old patient, should the nurse question? (Select all that apply.) A) Amiodarone (Cordarone) 400 mg orally per 24 hours B) Labetalol (Normodyne) 100 mg orally b.i.d. C) Phentolamine (Regitine) 1 mg intramuscularly 1 to 2 hours before surgery D) Prazosin (Minipress) 3 mg orally t.i.d. E) Carvedilol (Coreg) 6.25 mg orally b.i.d. - ✔️ ANS: A, B, E
The patient takes labetalol and is scheduled for surgery. The anesthesiologist plans to use halothane as one of the anesthetic agents. The nurse consults with the anesthesiologist to ensure awareness the patient's medication history knowing that the combination of labetalol and halothane will have what effect? A) Excessive hypotension B) Hypoglycemia C) Conduction system disturbances D) Vomiting - ✔️ ANS: A
A 31-year-old male patient has been prescribed propranolol to reduce and prevent angina. What will the nurse assess this patient for related to the medication? (Select all that apply.)
Questions,Answers and explanations
2023 - 2024 |Graded A+
A) Sleep disturbance B) Impotence C) Bronchospasm D) Gastric pain E) Tachycardia - ✔️ ANS: B , C, D
A 23-year-old female patient presents at the clinic with a migraine headache. What beta-adrenergic blocking agent might the physician prescribe for the prophylactic prevention of future migraine headaches? A) Propranolol (Inderal) B) Nadolol (Corgard) C) Timolol (Blocadren) D) Sotalol (Betapace) - ✔️ ANS: A
The nurse frequently administers propranolol (Inderal) as treatment for what condition? A. Hypotension B. Angina C. Prevent first myocardial infarction (MI) D. Cluster headaches - ✔️ ANS: B
In what patient is propranolol (Inderal) contraindicated? A) 26-year-old man with viral myocarditis B) 45-year-old woman with heart failure who suffered a myocardial infarction C) 42-year-old man with hypertension D) 65-year-old woman with persistent migraines - ✔️ ANS: B
A nurse is providing discharge instructions to a patient who is taking atenolol (Tenormin) to treat hypertension. What would the nurse teach the patient regarding a possible drugdrug interaction? A) Antibiotics B) Oral contraceptives C) Nonsteroidal anti-inflammatory drugs (NSAIDs) D) Antifungal agents - ✔️ ANS: C
The nurse is caring for a patient who is unconscious and requires an anticholinergic drug to treat bradycardia. What drug can the nurse administer IV for this purpose? A) Ipratropium (Atrovent) B) Dicyclomine (generic) C) Methscopolamine (Pamine)
Questions,Answers and explanations
2023 - 2024 |Graded A+
✔️ ANS: D
A 50-year-old female patient received atropine and meperidine (Demerol) preoperatively. After surgery, the patient complains of mouth dryness. What is the nurse's best response? A) Preoperative medications decrease saliva production but it is temporary and will improve. B) This is the result of all of the blood and fluid you lost during surgery. C) You are probably dehydrated. The IV fluids you are receiving will correct the problem. D) The preoperative medication causes an electrolyte imbalance making your mouth feel dry. - ✔️ ANS: A
The nurse is caring for a patient with atropine poisoning. What drug will the nurse administer to reverse these effects? A) Bethanechol B) Neostigmine C) Edrophonium D) Physostigmine - ✔️ ANS: D
The 2-year-old patient with asthma is placed on a short-term dose of prednisone. What important instruction will the nurse provide the patient about this drug? A. Increase intake of carbohydrates. B. The child may receive immunizations while on this drug. C. Do not stop this medication suddenly; you will have to taper dosage gradually. D. Reduce intake of protein until drug therapy is complete. - ✔️ ANS: C
What glucocorticoids could the nurse only administer orally? A) Cortisone (Cortone Acetate) B) Hydrocortisone (Cortef) C) Prednisone (Deltasone) D) Triamcinolone (Aristocort) - ✔️ ANS: C
The nurse administers prednisone orally at 8 am. When would the nurse expect the drug to reach peak effect? A) 9 to 10 am B) 12 to 1 pm C) 8:30 to 9:00 am D) 4 to 6 pm - ✔️ ANS: A
Questions,Answers and explanations
2023 - 2024 |Graded A+
The nurse is providing discharge teaching for a patient prescribed prednisone to be taken on alternate days. The patient asks why he cannot take half a pill every day. What is the nurse's best response? A) To eliminate adverse side effects B) To prolong therapeutic effects C) To prevent steroid tolerance D) To decrease adrenal suppression - ✔️ ANS: D
The nurse administers fludrocortisone (Florinef) to a patient diagnosed with salt- losing adrenogenital syndrome and then assesses for what therapeutic action? A) Development of hypokalemia and elevated serum glucose level B) An increase in sodium and water reabsorption and potassium excretion C) Headache, edema, weakness, arrhythmias, and hypertension D) Sodium and water depletion along with potassium retention - ✔️ ANS: B
The nurse is instructing a patient how to mix NPH insulin with regular insulin in one syringe. The nurse tells the patient the mixture must be administered within how long after it is prepared? A) 5 minutes B) 10 minutes C) 15 minutes D) 20 minutes - ✔️ ANS: C
A patient is admitted to the emergency department in diabetic ketoacidosis (DKA) with a blood glucose level of 485 mg/dL. The physician orders an initial dose of 25 U insulin IV. Which type of insulin will be administered? A) NPH insulin B) Humulin L insulin C) Humulin N insulin D) Regular insulin - ✔️ ANS: D
A patient with type 1 diabetes takes 12 units of regular insulin and 34 units of NPH insulin in the morning. How would the nurse explain why two different types of insulin are required to control the patient's blood sugar? A. Different onsets and peak effects extends blood glucose control. B. The mixture makes each drug work more effectively. C) The combination reduces the adverse effects experienced. D) Patients are less likely to experience hypoglycemia. - ✔️ ANS: A
