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RN Pharmacology Exam Review 2024 – 242 Tested
and Proven Questions with Expert Answers and
Rationales | Updated NCLEX Prep Resource
1. A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include? A. "Rinse your mouth after each use of this medication." B. "Limit fluid intake while taking this medication." C. "Increase your intake of vitamin B12 while taking this medication." D. "You can take the medication as needed." Correct Answer: A Rationale: Beclomethasone is an inhaled corticosteroid, which can increase the risk of oral candidiasis (fungal infection). Rinsing the mouth after use helps prevent this complication. 2. A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching? A. Take the albuterol at the same time each day. B. Administer the albuterol inhaler prior to using the beclomethasone inhaler. C. Use beclomethasone if experiencing an acute episode. D. Avoid shaking the beclomethasone before use. Correct Answer: B Rationale: Albuterol is a beta2-agonist that promotes bronchodilation and should be taken first to open airways, allowing the beclomethasone (a glucocorticoid) to be more effective when administered afterward. 3. A nurse is providing instructions to the parent of an adolescent client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include? A. "You can take this medication to abort an acute asthma attack." B. "Tremors are an adverse effect of this medication." C. "Prolonged use of this medication can cause hyperglycemia." D. "This medication can slow skeletal growth rate."
Correct Answer: B Rationale: Tremors are a common adverse effect of albuterol due to stimulation of beta2 receptors on skeletal muscle.
4. A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects? A. Weight gain B. Nervousness C. Bradycardia D. Constipation Correct Answer: A Rationale: Long-term prednisone use can lead to weight gain and fluid retention due to increased sodium and water retention. 5. A nurse is caring for a client who states she has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following adverse effects? A. Sedation B. Nasal congestion C. Productive cough D. Constipation Correct Answer: B Rationale: Prolonged use of phenylephrine nasal drops (more than 3–5 days) can cause rebound nasal congestion due to downregulation of alpha-adrenergic receptors. 6. A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects? A. Diarrhea B. Anxiety C. Sedation D. Palpitations
D. Drowsiness is an adverse reaction of this medication. Diphenhydramine is administered to treat insomnia. E. Urinary retention is an anticholinergic manifestation that can occur when a client takes diphenhydramine. A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicates an understanding of the teaching? A."I should use the spray every 4 hours while I am awake." B."It can take as long as 3 weeks before the medication takes a maximum effect." C."This medication can also be used to treat motion sickness." D."I can use this medication when my nasal passages are blocked. - - correct ans- - B. The client can see some benefits of the medication within a few hours, but the maximum benefits can take up to 3 weeks. A nursing is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A.Assess for tinnitus. B.Report urine output 50 mL/hr.
C. monitor serum potassium levels. D.Elevate the head of bed slowly before ambulation. E.Recommend eating a banana daily - - correct ans- - A. An adverse effect of furosemide is ototoxicity. manifestations of tinnitus should be reported to the provider C. A decrease in serum potassium levels is an adverse effect of furosemide, and the nurse should notify the provider. D. Slowly elevating the head of the bed will prevent the client from developing orthostatic hypotension, which is a manifestation of hypovolemia. E. A banana is high in potassium. The nurse should encourage the client to eat foods high in potassium to prevent hypokalemia. A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include? A.Take the medication with food.
and is receiving mannitol. Which of the following findings should the nurse report to the provider? A.Blood glucose 150 mg/dL B.Urine output 40 mL/hr C.Dyspnea D.Bilateral equal pupil size - - correct ans- - C. Dyspnea is a manifestation of heart failure, an adverse effect of mannitol. The nurse should stop the medication and notify the provider. A nurse is planning caring for a client who is has a new prescription for torsemide. The nurse should plan to monitor for which of the following adverse reactions of this medications? (Select all that apply.) A.Respiratory acidosis B. hypokalemia C. hypotension D.Ototoxicity E.Ventricular dysrhythmias - - correct ans- - B. The nurse should plan to monitor for hypokalemia, which is an adverse effect of a loop diuretic. C. The nurse should plan to monitor for hypotension.
D. The nurse should plan to monitor the client for ototoxicity. E. The nurse should plan to monitor for ventricular dysrhythmias, which is a manifestation of hypokalemia, an adverse effect of torsemide A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A.Asthma B.Glaucoma C. hypertension D.Tachycardia - - correct ans- - A. Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, so it is contraindicated in clients who have asthma A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include? A.Increase the amount of
A.Intestinal ileus B.Neutropenia C.Delirium D. hyperthermia - - correct ans- - C. Delirium and other mental status changes can occur in thiocyanate toxicity when IV nitroprusside is infused at a high dosage. monitor thiocyanate level during therapy to remain below 10 mg/dL. A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply.) A.Simvastatin B. hydrochlorothiazide C.Phenytoin D.Clonidine E.Aliskiren - - correct ans- - B.hydrochlorothiazide, a thiazide diuretic, is often used to treat hypertension. Diuretics can intensify first-dose orthostatic hypotension caused by captopril and can continue to interact with antihypertensive medications to cause hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril and keep the client safe from injury
D. Clonidine, a centrally acting alpha agonist, is an antihypertensive medication that can interact with captopril to intensify first-dose orthostatic hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril, and keep the client safe from injury. E. Aliskiren, a direct renin inhibitor, is an antihypertensive medication that can interact with captopril to intensify its first-dose orthostatic hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril, and keep the client safe from injury A nurse in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity? A.Calcium 9.2 mg/dL B.Calcium 10.3 mg/dL C.Potassium 3.4 mEq/L D.Potassium 4.8 mEq/ - - correct ans- - C. Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium can cause fatal dysrhythmias, especially in older clients who take
C.Decreased conduction through the AV node D.Vasoconstriction of renal blood vessel - - correct ans- - B. The nurse should expect dopamine to cause increased myocardial contractility, which also increases cardiac output. This occurs with the stimulation of beta receptors and is a positive inotropic effect of dopamine when it is administered at a low dose A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation digoxin toxicity? (Select all that apply.) A.Fatigue B.Constipation C.Anorexia D.Rash E.Diplopia - - correct ans- - A. Fatigue and weakness are early CNS findings that can indicate digoxin toxicity. C. GI disturbances, such as anorexia, are manifestations of digoxin toxicity.
E. Visual changes, such as diplopia and yellow-tinged vision, are manifestations of digoxin toxicity A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? A.Contact provider if heart rate is less than 60/min. B.Check pulse rate for 30 seconds and multiply result by 2. C.Increase intake of sodium. D.Take with food if nausea occur - - correct ans- - A. The client should contact the provider for a heart rate less than 60/min A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The clients asks, "What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make? A."Take two more sublingual tablets at the same time." B."Call the emergency response team."
and is to begin taking ranolazine. The nurse should report which of the following medications in the client's history that can interact with ranolazine? (Select all that apply.) A.Digoxin B.Simvastatin C.Verapamil D.Amlodipine E.Nitroglycerin transdermal patch - - correct ans- - A. Concurrent use with ranolazine increases serum levels of digoxin, so digoxin toxicity can result. B. Concurrent use with ranolazine increases serum levels of simvastatin, so liver toxicity can result. C. Verapamil is an inhibitor of CYP3A4, which can increase levels of ranolazine and lead to the dysrhythmia torsades de pointes. A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer? A.Furosemide
B.Captopril C.Ranolazine D. metoprolol - - correct ans- - D.metoprolol, a beta adrenergic blocker, is used to treat hypertension and stable angina pectoris, and is often prescribed to decrease heart rate in clients who have tachycardia A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions? A."Remove the prior dose before applying a new dose." B."Rub the ointment directly into your skin until it is no longer visible." C."Cover the applied ointment with a clean gauze pad." D."Apply the ointment to the same skin area each time. - - correct ans- - A. The client should remove the prior dose before applying a new dose to prevent toxicity A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of the following findings is a manifestation of amiodarone toxicity? A.Light yellow urine B.Report of tinnitus
A.Bruising B.Report of metallic taste C.muscle pain D.Report of anorexia - - correct ans- - D. Anorexia, blurred vision, stomach pain, and diarrhea are manifestations of digoxin toxicity A nurse is assessing a client who has taken procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following adverse effects of this medication? (Select all that apply.) A. hypertension B.Widened QRS complex C.Narrowed QT interval D.Easy bruising E.Swollen joints - - correct ans- - B. On the ECG, procainamide can cause a widened QRS complex, which is a manifestation of cardiotoxicity if the QRS complex becomes widened by more than 50% of the expected reference range D. Procainamide can cause bone marrow depression, with neutropenia (infection) and thrombocytopenia (easy bruising, bleeding)
E. Systemic lupus erythematosus-like syndrome can occur as an adverse effect of procainamide. manifestations include swollen, painful joints. Clients who take procainamide in large doses or for more than 1 year are at risk A nurse is preparing to administer propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take? A. hold propranolol for an apical pulse greater than 100/min. B.Administer propranolol to increase the client's blood pressure. C.Assist the client when she sits up or stands after taking this medication. D.Check for hypokalemia frequently due to the risk for propranolol toxicity. - - correct ans- - C. Propranolol can cause orthostatic hypotension, so it is important assess for dizziness during ambulation or when moving to a sitting position. A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching?
