NURSING PHARMACOLOGY 1 c.

Complaints of pain at the site of

infusion.
A 2-year-old child is receiving temporary
d. A rash on the client’s extremities.
total parenteral nutrition (TPN) through a
central venous line. This is the first day of Nurse Celine is caring for a client with
TPN therapy. Although all of the following clinical depression who is receiving an
nursing actions must be included in the plan MAO inhibitor. When providing instructions
of care of this child, which one would be a about precautions with this medication, the
priority at this time? nurse should instruct the client to:
a. Use aseptic technique during a. Avoid chocolate and cheese.
dressing changes. b. Take frequent naps.
b. Maintain central line catheter c. Take the medication with milk.
integrity. d. Avoid walking without assistance.
c. Monitor serum glucose levels.
While providing home care to a client with
d. Check results of liver function tests.
congestive heart failure, the nurse is asked
Nurse Jamie is administering the initial total how long diuretics must be taken.
parenteral nutrition solution to a client. The best response to this client should be:
Which of the following assessments requires
a. “As you urinate more, you will need
the nurse’s immediate attention?
less medication to control fluid.”
a. Temperature of 37.5 degrees Celsius. b. “You will have to take this
b. Urine output of 300 cc in 4 hours. medication for about a year.”
c. Poor skin turgor. c. “The medication must be continued
d. Blood glucose of 350 mg/dl. so the fluid problem is controlled.”
d. “Please talk to your physician about
Nurse Susan administered intravenous
medications and treatments.”
gamma globulin to an 18 month-old child
with AIDS. The parent asks why this George, age 8, is admitted with rheumatic
medication is being given. What is the fever. Which clinical finding indicates to the
nurse’s best response? nurse that George needs to continue taking
the salicylates he had received at home?
a. “It will slow down the replication of
the virus.” a. Chorea
b. “This medication will improve your b. Polyarthritis
child’s overall health status.” c. Subcutaneous nodules
c. “This medication is used to prevent d. Erythema marginatum
bacterial infections.”
An order is written to start an IV on a 74-
d. “It will increase the effectiveness of
year-old client who is getting ready to go to
the other medications your child
the operating room for a total hip
receives.”
replacement. What gauge of catheter
When caring for a client with total parenteral would best meet the needs of this client?
nutrition (TPN), what is the most important
a. 18
action on the part of the nurse?
b. 20
a. Record the number of stools per day. c. 21 butterfly
b. Maintain strict intake and output d. 25
records.
A client with an acute exacerbation of
c. Sterile technique for dressing change
rheumatoid arthritis is admitted to the
at IV site.
hospital for treatment. Which drug, used to
d. Monitor for cardiac arrhythmias.
treat clients with rheumatoid arthritis, has
The nurse is administering an intravenous both an anti-inflammatory and
vesicant chemotherapeutic agent to a client. immunosuppressive effect?
Which assessment would require the
a. Gold sodium thiomalate
nurse’s immediate action?
(Myochrysine)
a. Stomatitis lesion in the mouth. b. Azathioprine (Imuran)
b. Severe nausea and vomiting. c. Prednisone (Deltasone)
d. Naproxen (Naprosyn)
Which of the following is least likely to a. “Are you sure all this insulin won’t
influence the potential for a client to comply hurt my baby?”
with lithium therapy after discharge? b. “I’ll probably need my daily insulin
dose raised.”
a. The impact of lithium on the client’s
c. “I will continue to take my regular
energy level and lifestyle.
dose of insulin.”
b. The need for consistent blood level
d. “These finger sticks make my hand
monitoring.
sore. Can I do them less frequently?”
c. The potential side effects of lithium.
d. What the client’s friends think of his Mrs. Johanson’s physician has prescribed
need to take medication. tetracycline 500 mg po q6h. While assessing
Mrs. Johanson’s nursing history for
A male patient is to receive a percutaneously
allergies, the nurse notes that Mrs.
inserted central catheter (PICC). He asks the
Johanson’s is also taking oral
nurse whether the insertion will hurt. How
contraceptives. What is the most appropriate
will the nurse reply?
initial nursing intervention?
a. “You will have general anesthesia so
a. Administer the dose of tetracycline.
you won’t feel anything.”
b. Notify the physician that Mrs.
b. “It will be inserted rapidly, and any
Johanson is taking oral
discomfort is fleeting.”
contraceptives.
c. “The insertion site will be
c. Tell Mrs. Johanson, she should stop
anesthetized. Threading the catheter
taking oral contraceptives since they
through the vein is not painful.”
are inactivated by tetracycline.
d. “You will receive sedation prior to
d. Tell Mrs. Johanson, to use another
the procedure.”
form of birth control for at least two
The nurse is caring for an elderly client who months.
has been diagnosed as having sundown
An adult client’s insulin dosage is 10 units
syndrome. He is alert and oriented during
of regular insulin and 15 units of NPH
the day but becomes disoriented and
insulin in the morning. The client should be
disruptive around dinnertime. He is
taught to expect the first insulin peak:
hospitalized for evaluation. The nurse asks
the client and his family to list all of the a. As soon as food is ingested.
medications, prescription and b. In two to four hours.
nonprescription, he is currently taking. What c. In six hours.
is the primary reason for this action? d. In ten to twelve hours.
a. Multiple medications can lead to An adult is hospitalized for treatment of
dementia. deep electrical burns. Burn wound sepsis
develops and mafenide acetate 10%
b. The medications can provide clues
(Sulfamylon) is ordered BID. While
regarding his medical background.
applying the Sulfamylon to the wound, it is
c. Ability to recall medications is a good important for the nurse to prepare the client
assessment of the client’s level of for expected responses to the topical
orientation. application, which include:

d. Medications taken by a client are part of a. Severe burning pain for a few
every nursing assessment. minutes following application.
b. Possible severe metabolic alkalosis
A 25-year-old woman is in her fifth month with continued use.
of pregnancy. She has been taking 20 units c. Black discoloration of everything
of NPH insulin for diabetes mellitus daily that comes in contact with this drug.
for six years. Her diabetes has been well d. Chilling due to evaporation of
controlled with this dosage. She has been solution from the moistened
coming for routine prenatal visits, during dressings.
which diabetic teaching has been
implemented. Which of the following Ms.Clark has hyperthyroidism and is
statements indicates that the woman scheduled for a thyroidectomy. The
understands the teaching regarding her physician has ordered Lugol’s solution for
insulin needs during her pregnancy? the client. The nurse understands that the
primary reason for giving Lugol’s solution c. Theophylline toxicity
preoperatively is to: d. Ineffective theophylline
a. Decrease the risk of agranulocytosis The client at highest risk for nephrotoxicity
postoperatively. with aminoglycoside use is a:
b. Prevent tetany while the client is
a. Male with a creatinine of 1.7 and
under general anesthesia.
BUN of 52 on a 10-day regimen.
c. Reduce the size and vascularity of
b. Female with BUN of 12 and
the thyroid and prevent hemorrhage.
creatinine of 0.8
d. Potentiate the effect of the other
c. Female with past history of cystitis
preoperative medication so less
on 5 days of therapy.
medicine can be given while the
d. Male with history of kidney stones
client is under anesthesia.
on 8 days of therapy.
A two-year-old child with congestive heart
When assessing clients for evidence of a
failure has been receiving digoxin for one
penicillin allergy, which of the following
week. The nurse needs to recognize that an
symptoms may not be considered to be a
early sign of digitalis toxicity is:
true hypersensitivity reaction?
a. Bradypnea
a. Wheezing
b. Failure to thrive
b. Nausea
c. Tachycardia
c. Urticaria
d. Vomiting
d. Angioneurotic edema
Mr. Bates is admitted to the surgical ICU
All of the following symptoms are evidence
following left adrenalectomy. He is sleepy
of a superinfection except:
but easily aroused. An IV containing
hydrocortisone is running. The nurse a. White oral plaques
planning care for Mr. Bates knows it is b. Creamy vaginal discharge
essential to include which of the following c. Skin rash
nursing interventions at this time? d. Darkened tongue
a. Monitor blood glucose levels every Which of the following statements
shift to detect the development of is true when educating clients about
hypo- or hyperglycemia. penicillin therapy?
b. Keep flat on back with minimal
movement to reduce the risk of a. The client must take the medication
hemorrhage following surgery. at evenly spaced intervals.
c. Administer hydrocortisone until vital b. The client may save leftover
signs stabilize, then discontinue the medication for a future illness.
IV. c. If signs of an allergic reaction,
d. Teach Mr. Bates how to care for his
continue the medication and notify
the physician.
wound since he is at high risk for
developing postoperative infection. d. Clients taking oral contraceptives
must be cautioned to use an alternate
Corinne is experiencing diarrhea after form of birth control while being
consuming her prescribed antibiotics for the treated with penicillin.
whole week. This is because:
Antonietta is taking antitubercular,
a. The drugs render food indigestible. the most common adverse effect she may be
b. Gastric flora is disturbed. experiencing is:
c. Fluid is added into the intestine.
d. Normal intestinal bacteria are a. Red-orange discoloration of urine
destroyed. b. Hypersensitivity
c. Hepatotoxicity
When a client with chronic obstructive d. CHF
pulmonary disease is taking theophylline
also receives ciprofloxacin (Cipro), which of In treatment of tuberculosis, the therapeutic
the following interactions would occur? rationale for combination drug therapy is to:

a. Cipro Toxicity a. Decrease cost and improve

b. Ineffectiveness of ciprofloxacin compliance.
 b. Reduce the incidence of cumulative Which of the following must always be
effects. present before beginning antifungal therapy?
c. Increase blood dyscrasias.
a. Coagulation profile
d. Decrease emergence of drug-
b. Confirmed diagnosis
resistance strains.
c. Biopsy of the infected site
Changes in visual acuity and color d. Urinalysis
perception are associated with treatment by
Which choice describes the action of
which of the following agents?
nucleoside analogs?
a. INH (isoniazid)
a. Exert anti-HIV activity at the reverse
b. PZA (pyrazinamide)
transcriptase level and cause
c. ETH (ethambutol)
premature termination of viral DNA
d. SM (streptomycin)
chain synthesis.
Which of the following groups of b. Completely stop the replication of
antitubercular agents includes first-line HIV virus.
agents? c. Allow for a patient to become non-
contagious after taking for at least 3
a. INH, PZA, RIF
days.
b. SM, PAS, INH
d. Are all equally effective and free of
c. EMB, PAS, INH
side effects.
d. INH, cycloserine, RIF
Which of the following is true about
Antitubercular therapy may be determined
protease inhibitors?
ineffective when:
a. Work better when used alone.
a. Sputums are negative
b. Are the same as nucleoside analogs.
b. Symptoms resolve
c. Affect replication of HIV at different
c. Hepatitis results
stages than nucleoside analogs.
d. Drug-resistant bacteria emerge
d. Have a high level of toxicity.
Fluconazole (Diflucan) can be administered
The human cells specifically affected by
to a client with:
HIV are:
a. Pneumococcal meningitis
a. Gonocytes
b. Oral thrush
b. CD4+ T lymphocytes
c. Cryptococcal meningitis
c. Islet cells
d. Pneumococcal pneumonia
d. Red blood cells
When administering amphotericin B, which
Which of the following statements is true
of the following must be used?
about monotherapy for treatment of HIV
B. A diluent of 5% dextrose with no disease?
preservatives
a. It is the only FDA-approved
Which of the following nursing diagnoses treatment for HIV disease.
might occur when administering large b. It is able to effectively destroy all
parenteral doses of amphotericin B with viral particles of HIV.
vancomycin (Vancocin)? c. It interferes with the replication of
HIV virus without causing any side
a. Decreased cardiac output effects.
b. Ineffective airway clearance d. It appears to cause rapid resistance.
c. Ineffective breathing pattern
d. Fluid volume excess Which of the following statements is true
about combination therapy for the treatment
Arvic, a 16-year-old student, has acquired of HIV disease?
systemic fungal infection, he should be
treated with: a. It completely shuts off replication of
HIV.
a. Amphotericin B (Fungizone) b. Is the only FDA-approved treatment
b. Miconazole (Monistat IV) for HIV disease.
c. Ketoconazole (Nizoral) c. It appears to cause a sustained
d. Griseofulvin (Fulvicin) benefit achieved by drug no. 1
 preventing the emergence of c. Report pruritus.
resistance to drug no. 2 despite d. Report pruritus.
resistance to drug no. 1.
Topical antibiotics work by:
d. It is only effective if used alternating
with periods of monotherapy. a. Inhibiting replication of a virus.
b. Blocking histamine-1 and -2
When administering topical ophthalmic
receptors.
preparations, the nurse must assess:
c. Binding to fungal cell membranes.
a. Visual acuity d. Inhibiting bacterial cell wall
b. Intraocular movements synthesis.
c. Color of the sclera
Pediculicides are used to treat which of the
d. Blinking reflex
following disorders?
Which of the following drugs might be
a. Scabies
given to relieve pain from corneal
b. Fungal infections
abrasions?
c. Viral infections
a. Proparacaine hydrochloride d. Head lice
(Alcaine)
Alice is using antiviral creams for her
b. Timolol maleate (Timoptic)
genital herpes. Which of the following is a
c. Betaxolol hydrochloride (Betoptic)
potential side effect of the medication?
d. Levobunolol hydrochloride
(Betagan) a. Vulvitis
b. Headache
Drugs that lower intraocular pressure work
c. Dizziness
by increasing:
d. Staining of the skin
a. The flow of aqueous humor through
the anterior chamber.
b. Fluid volume in the eye's anterior PHARMACOLOGY EXAM 2
chamber.
c. Pressure in the eye chambers. The nursery nurse is putting erythromycin
d. Diameter of the eye chambers. ointment in the newborn’s eyes to prevent
infection. She places it in which of the
When administering otic preparations, the following area of the eye:
nurse should observe the tympanic
membrane for: a. Under the eyelid.
b. On the cornea.
a. Erythema c. In the lower conjunctival sac.
b. Perforation d. By the optic disc.
c. Fluid
d. All of the above The physician orders penicillin for a patient
with streptococcal pharyngitis. The nurse
Mara Francesca has been diagnosed with administers the drug as ordered, and the
scabies. His physician has ordered patient has an allergic reaction. The nurse
crotamiton (Eurax). After 1 week of checks the medication order sheet and finds
treatment, the client reports that the pruritus that the patient is allergic to penicillin. Legal
has not stopped. You would advise the client responsibility for the error is:
to:
a. Only the nurse’s—she should have
a. Stop applying the medication. checked the allergies before
b. Continue treatment because pruritus administering the medication.
may persist for 4 to 6 weeks. b. Only the physician’s—she gave the
c. Call the physician. order, the nurse is obligated to follow
d. None of the above. it.
c. Only the pharmacist’s—he should
Jake has psoriasis of the scalp. The
alert the floor to possible allergic
physician has ordered Zetar shampoo. You
reactions.
would advise the client to:
d. The pharmacist, physician, and nurse
a. Avoid sun exposure to the scalp. are all liable for the mistake.
b. Use the shampoo PRN.
James Perez, a nurse on a geriatric floor, is tells you she is still experiencing severe
administering a dose of digoxin to one of his pain. Your action should be to
patients. The woman asks why she takes a
a. Give her the next ordered dose of MS.
different pill than her niece, who also has
heart trouble. James replies that as people b. Give her a back rub, put on some light
get older, liver and kidney function decline, music, and dim the lights in the room.
and if the dose is as high as her niece’s, the
drug will tend to: c. Report your findings to the MD,
requesting an alternate medication order to
a. Have a shorter half-life. be obtained from the physician.
b. Accumulate.
d. Call her daughter to come and sit with her
c. Have decreased distribution.
d. Have increased absorption. When counseling a patient who is starting to
The nurse is administering augmentin to her take MAO (monoamine oxidase) inhibitors
patient with a sinus infection. Which is the such as Nardil for depression, it is essential
best way for her to ensure that she is giving that they be warned not to eat foods
it to the right patient? containing tyramine, such as:

a. Call the patient by name. a. Roquefort, cheddar, or Camembert

b. Read the name of the patient on the cheese.
patient’s door. b. Grape juice, orange juice, or raisins.
c. Check the patient’s wristband. c. Onions, garlic, or scallions.
d. Check the patient’s room number on d. Round beef, turkey, or pork.
the unit census list. The physician orders an intramuscular
The most important instructions a nurse can injection of Demerol for the
give a patient regarding the use of the postoperativepatient’s pain. When preparing
antibiotic ampicillin prescribed for her are to to draw up the medication, the nurse is
careful to remove the correct vial from the
a. Call the physician if she has any narcotics cabinet. It is labeled
breathing difficulties.
b. Take it with meals so it doesn’t cause a. Simethicone.
an upset stomach. b. Albuterol.
c. Take all of the medication prescribed c. Meperidine.
even if the symptoms stop sooner. d. Ibuprofen.
d. Not share the pills with anyone else. The nurse is administering an antibiotic to
Mr. Jessie Ray, a newly admitted patient, her pediatric patient. She checks the
has a seizure disorder which is being treated patient’s armband and verifies the correct
with medication. Which of the following medication by checking the physician’s
drugs would the nurse question if ordered order, medication Kardex, and vial. Which
for him? of the following is not considered one of the
ten “rights” of drug administration?
a. phenobarbital (Solfoton) 150 mg hs
b. amitriptyline (Elavil), 10 mg QID a. Right dose
c. valproic acid (Depakote), 150 mg b. Right route
BID c. Right effect
d. phenytoin (Dilantin), 100 mg TID d. Right time

Mrs. Jane Gately has been dealing with A nurse is preparing the client’s morning
uterine cancer for several months. Pain NPH insulin dose and notices a clumpy
management is the primary focus of her precipitate inside the insulin vial. The nurse
should:
current admission to your oncology unit. Her
vital signs on admission are BP 110/64, a. Draw up and administer the dose.
pulse 78, respirations 18, and temperature b. Shake the vial in an attempt to
99.2 F. Morphine sulfate 6mg IV, q 4 hours, disperse the clumps.
prn has been ordered. During your c. Draw the dose from a new vial.
assessment after lunch, your findings are BP d. Warm the bottle under running water
92/60, pulse 66, respirations 10, and to dissolve the clump.
temperature 98.8. Mrs. Gately is crying and
A client with histoplasmosis has an order for b. Aspercreme
ketoconazole (Nizoral). The nurse teaches c. Myoflex
the client to do which of the following while d. Acetic acid solution
taking this medication?
A nurse is providing instructions to a client
a. Take the medication on an empty regarding quinapril hydrochloride
stomach. (Accupril). The nurse tells the client:
b. Take the medication with an antacid.
a. To take the medication with food
c. Avoid exposure to sunlight.
only.
d. Limit alcohol to 2 ounces per day.
b. To rise slowly from a lying to a
A nurse has taught a client taking a xanthine sitting position.
bronchodilator about beverages to avoid. c. To discontinue the medication if
The nurse determines that the client nausea occurs.
understands the information if the client d. That a therapeutic effect will be
chooses which of the following beverages noted immediately.
from the dietary menu?
Auranofin (Ridaura) is prescribed for a
a. Chocolate milk client with rheumatoid arthritis, and the
b. Cranberry juice nurse monitors the client for signs of an
c. Coffee adverse effect related to the medication.
d. Cola Which of the following indicates an adverse
effect?
A client who is taking famotidine (Pepcid)
asks the home care nurse what would be the a. Nausea
best medication to take for a headache. The b. Diarrhea
nurse tells the client that it would be best to c. Anorexia
take: d. Proteinuria
a. aspirin (acetylsalicylic acid, ASA) A client has been taking benzonatate
b. ibuprofen (Motrin) (Tessalon) as ordered. The nurse tells the
c. acetaminophen (Tylenol) client that this medication should do which
d. naproxen (Naprosyn) of the following?
A nurse is planning dietary counseling for a. Take away nausea and vomiting.
the client taking triamterene (Dyrenium). b. Calm the persistent cough.
The nurse plans to include which of the c. Decrease anxiety level.
following in a list of foods that are d. Increase comfort level.
acceptable?
During surgery, there is an increased
a. Baked potato potential for arrhythmias when
b. Bananas catecholamines are given with:
c. Oranges
a. halothane (Fluothane)
d. Pears canned in water
b. digoxin (Lanoxin)
A client with advanced cirrhosis of the liver c. bupivacaine (Marcaine)
is not tolerating protein well, as evidenced d. lidocaine (Xylocaine)
by abnormal laboratory values. The nurse
General anesthetics potentiate the effects of
anticipates that which of the following
which of the following drugs?
medications will be prescribed for the
client? a. Depolarizing agents
b. Skeletal muscle relaxants
a. lactulose (Chronulac)
c. Volatile liquids
b. ethacrynic acid (Edecrin)
d. Inhalation anesthetics
c. folic acid (Folvite)
d. thiamine (Vitamin B1) The most dangerous metabolic side effect of
general anesthesia that can occur during
A female client tells the clinic nurse that her
surgery is:
skin is very dry and irritated. Which product
would the nurse suggest that the client apply a. Hyperglycemia
to the dry skin? b. Hyperthermia
c. Hypoglycemia
a. Glycerin emollient
 d. Hypothermia d. Paralysis
Mr. Baltazar will be undergoing surgery A client received lidocaine viscous before a
with general anesthesia. The client should be gastroscopy was performed. Following the
given which of the following instructions procedure, the nurse places a priority on
preoperatively? what assessment?
a. Eat a big breakfast a. Return of the gag reflex
b. Expect to be incontinent of urine b. Ability to urinate
postoperatively c. Abdominal pain
c. Double your medication doses d. Ability to stand
d. Expect nausea, vomiting, shivering,
The nurse observes a co-worker preparing to
and pain postoperatively
administer a solution of lidocaine and
Geneva is reviewing for her upcoming quiz epinephrine to a client with multiple
in Pharmacology. She should be aware that premature ventricular contractions. The
local and regional anesthesia act by: appropriate action by the nurse is to:
a. Inhibiting depolarization. a. Offer to monitor the client's heart
b. Increasing depolarization. rhythm.
c. Producing a semiconscious state. b. Notify the supervisor of the error.
d. Inhibiting motor movement. c. Do nothing; the drug choice is
correct.
Which of the following statements about
d. Prevent the administration and give a
shivering is correct?
plain lidocaine solution.
a. Shivering is a response controlled by
During induction of anesthesia, the nurse
the brainstem.
notes the client becomes hyperactive and
b. Shivering can occur in the absence of
physically resists the treatment. The nurse
hypothermia.
concludes what interventions are needed?
c. Shivering is effectively treated with
small doses of naloxone. a. Anesthesia must be discontinued.
d. Shivering is an uncomfortable, b. An intravenous drug will be given to
though harmless, effect of calm the client.
anesthesia. c. Anesthesia must be continued
d. The surgery will need to be
Early signs and symptoms of local
rescheduled.
anesthetic toxicity include all but one of the
following. Indicate the exception: The nurse receives the client in the
postanesthesia care unit (PACU) following a
a. Tinnitus
procedure requiring general anesthesia.
b. Perioral numbness
The most important assessment made by the
c. Dizziness
nurse relates to the client’s:
d. Hypertension
a. Level of consciousness.
A preoperative patient receives atropine
b. Pain.
before induction of anesthesia. The nurse
c. Vital signs.
caring for this patient understands that this
d. Respiratory status
agent is used to prevent:
Nurse Gretchen is discussing the use of
a. Anxiety.
cocaine as a local anesthetic with a nursing
b. Bradycardia.
student. Which statement by the student
c. Dry mouth.
indicates understanding of this agent?
d. Hypertension.
a. "Anesthetic effects develop slowly
The nurse teaching a client who will receive
and persist for several hours."
thiopental (Pentothal) as an anesthetic
b. "Cocaine is a local anesthetic
explains what common adverse effects
administered by injection."
might occur?
c. "Vasoconstrictors should not be used
a. Headache as adjunct agents with this drug."
b. Emergence delirium d. "When abused, cocaine causes
c. Nausea and vomiting physical dependence."
The client asks the nurse to explain the b. Codeine causes diarrhea, so the
action of infiltration anesthesia. The nurse’s client must take an additional drug to
response is based on the knowledge that prevent this.
infiltration anesthesia: c. Codeine is very constipating.
d. Codeine is antitussive in high doses.
a. Is applied only to mucous
membranes to provide local A client went to a health care facility to ask
anesthesia. for instructions regarding how to administer
b. Blocks a specific group of nerves in ophthalmic medications. The nurse correctly
tissues close to the operative area. instructs the client to?
c. Blocks sensation to an entire limb, or
a. Gently allow the tip of the optic
a large area of the face.
bottle to touch with the conjunctival
d. Produces numbing to large, regional
sac.
areas such as the lower abdomen and
b. Apply gentle pressure with a clean
legs.
tissue to the nasolacrimal duct for 30
All narcotics, regardless of their origin, seconds after the administration.
reduce pain by: c. Blink quickly to stimulate tearing
after the administration.
a. Stimulating opiate receptors.
d. Blow the nose to stimulate faster
b. Promoting the release of excitatory
absorption.
transmitters.
c. Releasing large quantities of The client is receiving an eye ointment and
endorphin. an eye drop. The nurse instructs the client
d. Blocking the mu receptors. to?
In addition to analgesia, narcotic effects a. Administer the eye ointment first,
include: followed by the eye drop.
b. Administer the eye drop first,
a. Euphoria, diarrhea, increased
followed by the eye ointment.
respirations
c. Administer the eye ointment, wait
b. Euphoria, miosis, nausea and
for 5 minutes then administer the eye
vomiting
drop.
c. Respiratory depression, increased
d. Administer the eye drop, wait for 10
blood pressure
minutes then administer the eye
d. Dependence, seizures, muscle
ointment.
spasms
The nurse is preparing to administer
The half-life of morphine is:
cyclopentolate (Cyclogyl) who will undergo
a. 4 to 6 hours a corneal surgery. The nurse administers the
b. 2 to 4 hours medication, knowing that the purpose of this
c. 6 to 8 hours eye drop is to?
d. 30 minutes to 1 hour
a. Dilate the pupil of the operative eye.
Which of the following statements about b. Constrict the pupil of the operative
morphine is correct? eye.
c. Reduces intraocular pressure.
a. Morphine is contraindicated in pain d. Lubricate the operative eye.
relief caused by head injury.
b. Morphine's withdrawal symptoms A client with glaucoma is receiving
cannot be relieved by methadone. betaxolol hydrochloride (Betoptic) eye
c. Morphine is most effective by drops. Which of the following interventions
parenteral administration. will the nurse likely do before the
d. Morphine quickly enters all body administration?
tissues.
a. Assessing orientation.
When administering codeine, the nurse b. Assessing peripheral pulses.
should be aware that: c. Monitor blood sugar level.
d. Monitor pulse rate.
a. Codeine produces more sedation
than other opiates. A miotic medication has been given to a
patient with glaucoma. The nurse tells the
client that the purpose of this medication is A nurse is providing instructions to a client
to? with an impacted cerumen who is prescribed
with Carbamide peroxide (Debrox). Which
a. It blocks the responses that are sent
of the following teachings made by the nurse
to the eye muscles.
indicates further research?
b. It will relax the eye muscles and
decrease blurring of vision. a. Do not touch the dropper tip or let it
c. It will constrict the eye to reduce touch your ear or any other surface.
intraocular pressure. b. Lie on your side or tilt the affected
d. It will dilate the eye to reduce ear upward. Hold the dropper
intraocular pressure. directly over the ear and place 5 to
10 drops into the ear canal.
A client went to a health care facility with a
c. Hold the earlobe up and back.
complaint of difficulty opening the eyelid
d. Use a cold preparation of the
because of pain. The physician diagnosed
medication.
the client with keratitis and is prescribed
with an eye lubricant. Which of the
following medicines should the nurse expect
PHARMACOLOGY EXAM 3
to administer?
An infection in a central venous access
a. hydroxypropyl methylcellulose
device is not eliminated by giving antibiotics
(Lacril).
through the catheter. How would bacterial
b. pilocarpine hydrochloride (Isopto
glycocalyx contribute to this?
Carpine).
c. timolol maleate (Timoptic). a. It protects the bacteria from
d. apraclonidine (Lopidine). antibiotic and immunologic
destruction.
The nurse is monitoring a client with
b. Glycocalyx neutralizes the antibiotic
glaucoma. Which of the following drugs, if
rendering it ineffective.
prescribed for the client, would the nurse
c. It competes with the antibiotic for
question?
binding sites on the microbe.
a. metipranolol (Optipranolol). d. Glycocalyx provides nutrients for
b. brimonidine (Alphagan P). microbial growth.
c. dorzolamide (Trusopt).
Central venous access devices are beneficial
d. atropine (Isopto Atropine).
in pediatric therapy because:
The nurse prepares an adult client for an ear
a. They don’t frighten children.
irrigation as ordered by the physician.
b. Use of the arms is not restricted.
Which of the following procedures was
c. They cannot be dislodged.
correctly performed by the nurse?
d. They are difficult to see.
a. Position the client with the affected
How can central venous access devices
side up after the irrigation.
(CVADs) be of value in a patient receiving
b. Pull the pinna down and back.
chemotherapy who has stomatitis and severe
c. Warm the irrigating solution to 98º
diarrhea?
Fahrenheit.
d. Directs a slow steady current of a. The chemotherapy can be rapidly
irrigating solution into the eardrum. completed allowing the stomatitis
and diarrhea to resolve.
The nurse is reviewing the drug list of an
b. Crystalloid can be administered to
elderly client who is taking a lot of
prevent dehydration.
medications given by different health care
c. Concentrated hyperalimentation fluid
provider. The client reports that “Lately,
can be administered through the
there has been roaring in my ears”. Which
CVAD.
medication would the nurse determine could
d. The chemotherapy dose can be
be responsible for the client’s complaint?
reduced.
a. amoxicillin (Amoxil).
Some central venous access devices
b. carvedilol (Coreg).
(CVAD) have more than one lumen. These
c. atropine sulfate (Isopto Atropine).
multi-lumen catheters:
d. aspirin (Ecotrin).
 a. Have an increased risk of infiltration. What volume of air can safely be infused
b. Only work a short time because the into a patient with a central venous access
small-bore clots off. device (CVAD)?
c. Are beneficial to patient care but are
a. It is dependent on the patient’s
prohibitively expensive.
weight and height.
d. Allow different medications or
b. Air entering the patient through a
solutions to be administered
CVAD will follow circulation to the
simultaneously.
lungs where it will be absorbed and
Some institutions will not infuse a fat cause no problems.
emulsion, such as Intralipid, into central c. It is dependent on comorbidities such
venous access devices (CVAD) because: as asthma or chronic obstructive lung
disease.
a. Lipid residue may accumulate in the
d. None.
CVAD and occlude the catheter.
b. If the catheter clogs, there is no Kent, a new staff nurse asks her preceptor
treatment other than removal and nurse how to obtain a blood sample from a
replacement. patient with a portacath device. The
c. Lipids are necessary only in the most preceptor nurse teaches the new staff nurse:
extreme cases to prevent essential
a. The sample will be withdrawn into a
fatty acid (EFA) deficiency
syringe attached to the Portacath
d. Fat emulsions are very caustic.
needle and then placed into a
A male patient needs a percutaneously vacutainer.
inserted central catheter (PICC) for b. Portacath devices are not used to
prolonged IV therapy. He knows it can be obtain blood samples because of the
inserted without going to the operating risk of clot formation.
room. He mentions that, “at least the doctor c. The vacutainer will be attached to
won’t be wearing surgical garb, will he?” the Portacath needle to obtain a
How will the nurse answer the patient? direct sample.
d. Any needle and syringe may be
a. “You are correct. It is a minor
utilized to obtain the sample.
procedure performed on the unit and
does not necessitate surgical attire.” What is the purpose of “Tunneling”
b. “To decrease the risk of infection, (inserting the catheter 2-4 inches under the
the doctor inserting the PICC will skin) when the surgeon inserts a Hickman
wear a cap, mask, and sterile gown central catheter device?
and gloves.”
a. Increases the patient’s comfort level.
c. “It depends on the doctor’s
b. Decreases the risk of infection.
preference.”
c. Prevents the patient’s clothes from
d. “Most doctors only wear sterile
having contact with the catheter.
gloves, not a cap, mask, or sterile
d. Makes the catheter less visible to
gown.”
other people.
A male patient is to receive a percutaneously
The primary complication of a central
inserted central catheter (PICC). He asks the
venous access device (CVAD) is:
nurse whether the insertion will hurt. How
will the nurse reply? a. Thrombus formation in the vein.
b. Pain and discomfort.
a. “You will have general anesthesia so
c. Infection.
you won’t feel anything.”
d. Occlusion of the catheter as the
b. “It will be inserted rapidly, and any
result of an intra-lumen clot.
discomfort is fleeting.”
c. “The insertion site will be Nurse Blessy is doing some patient
anesthetized. Threading the catheter education related to a patient’s central
through the vein is not painful.” venous access device. Which of the
d. “You will receive sedation prior to following statements will the nurse make to
the procedure.” the patient?
a. “These types of devices are
essentially risk-free.”
 b. “These devices seldom work for a. Prostate cancer.
more than a week or two b. Thyroid cancer.
necessitating replacement.” c. Renal carcinoma.
c. “The dressing should only be d. Neuroblastoma.
changed by your doctor.”
Serotonin release stimulates vomiting
d. “Heparin is instilled into the lumen
following chemotherapy. Therefore,
of the catheter to decrease the risk of
serotonin antagonists are effective in
clotting.”
preventing and treating nausea and vomiting
The chemotherapeutic DNA alkylating related to chemotherapy. An example of an
agents such as nitrogen mustards are effective serotonin antagonist antiemetic is:
effective because they:
a. ondansetron (Zofran).
a. Cross-link DNA strands with b. fluoxetine (Prozac).
covalent bonds between alkyl groups c. paroxetine (Paxil).
on the drug and guanine bases on d. sertraline (Zoloft).
DNA.
Methotrexate, the most widely used
b. Have few, if any, side effects.
antimetabolite in cancer chemotherapy does
c. Are used to treat multiple types of
not penetrate the central nervous system
cancer.
(CNS). To treat CNS disease this drug must
d. Are cell cycle-specific agents.
be administered:
Hormonal agents are used to treat some
a. Intravenously.
cancers. An example would be:
b. Subcutaneously.
a. Thyroxine to treat thyroid cancer. c. Intrathecally.
b. ACTH to treat adrenal carcinoma. d. By inhalation.
c. Estrogen antagonists to treat breast
Methotrexate is a folate antagonist. It
cancer.
inhibits enzymes required for DNA base
d. Glucagon to treat pancreatic
synthesis. To prevent harm to normal cells, a
carcinoma.
fully activated form of folic acid known as
Chemotherapeutic agents often produce a leucovorin (folinic acid; citrovorum factor)
certain degree of myelosuppression can be administered. Administration of
including leukopenia. Leukopenia does not leucovorin is known as:
present immediately but is delayed several
a. Induction therapy.
days to weeks because:
b. Consolidation therapy.
a. The patient’s hemoglobin and c. Pulse therapy.
hematocrit are normal. d. Rescue therapy.
b. Red blood cells are affected first.
A male patient is undergoing chemotherapy
c. Folic acid levels are normal.
may also be given the drug allopurinol
d. The current white cell count is not
(Zyloprim, Aloprim). Allopurinol inhibits
affected by chemotherapy.
the synthesis of uric acid. Concomitant
Currently, there is no way to prevent administration of allopurinol prevents:
myelosuppression. However, there are
a. Myelosuppression.
medications available to elicit a more rapid
b. Gout and hyperuricemia.
bone marrow recovery. An example is:
c. Pancytopenia.
a. epoetin alfa (Epogen, Procrit). d. Cancer cell growth and replication.
b. glucagon (Glucagen).
Superficial bladder cancer can be treated by
c. fenofibrate (Tricor).
direct instillation of the antineoplastic
d. lamotrigine (Lamictal).
antibiotic agent mitomycin (Mutamycin).
Estrogen antagonists are used to treat This process is termed:
estrogen hormone-dependent cancer, such as
a. Intraventricular administration.
breast carcinoma. Androgen antagonists
b. Intravesical administration.
block testosterone stimulation of androgen-
c. Intravascular administration.
dependent cancers. An example of an
d. Intrathecal administration.
androgen-dependent cancer would be:
The most common dose-limiting toxicity of cytochrome p-450 system. He has been on
chemotherapy is: this medication for 6 months. At this time,
he is started on a second medication (Drug
a. Nausea and vomiting.
B) that is an inducer of the cytochrome p-
b. Bloody stools.
450 system. You should monitor this patient
c. Myelosuppression.
for:
d. Inability to ingest food orally due to
stomatitis and mucositis. a. Increased therapeutic effects of Drug
A.
Chemotherapy induces vomiting by:
b. Increased adverse effects of Drug B.
a. Stimulating neuroreceptors in the c. Decreased therapeutic effects of
medulla. Drug A.
b. Inhibiting the release of d. Decreased therapeutic effects of
catecholamines. Drug B.
c. Autonomic instability.
Epinephrine is administered to a female
d. Irritating the gastric mucosa.
patient. The nurse should expect this agent
Myeloablation using chemotherapeutic to rapidly affect:
agents is useful in cancer treatment because:
a. Adrenergic receptors.
a. It destroys the myelocytes (muscle b. Muscarinic receptors.
cells). c. Cholinergic receptors.
b. It reduces the size of the cancer d. Nicotinic receptors.
tumor.
A nurse is providing instructions to a client
c. After surgery, it reduces the amount
receiving baclofen (Lioresal). Which of the
of chemotherapy needed.
following would be included in the teaching
d. It destroys the bone marrow prior to
plan?
transplant.
a. Limit fluid intake.
Anticipatory nausea and vomiting associated
b. Hold the medication if diarrhea
with chemotherapy occurs:
occurs.
a. Within the first 24 hours after c. Restrict alcohol intake.
chemotherapy. d. Notify the physician if weakness
b. 1-5 days after chemotherapy. occurs.
c. Before chemotherapy administration.
A nurse is analyzing the laboratory studies
d. While chemotherapy is being
on a client receiving dantrolene sodium
administered.
(Dantrium). Which of the following
Medications bound to protein have the laboratory tests would identify an adverse
following effect: effect associated with the use of the
medication?
a. Enhancement of drug availability.
b. Rapid distribution of the drug to a. Blood urea nitrogen
receptor sites. b. Creatinine
c. The more drug bound to protein, the c. Liver function test
less available for the desired effect. d. Triglyceride
d. Increased metabolism of the drug by
A nurse is caring for a client who is
the liver.
receiving cyclobenzaprine hydrochloride
Some drugs are excreted into bile and (Flexeril) for the treatment of muscle spasm.
delivered to the intestines. Prior to Which of the following medical conditions
elimination from the body, the drug may be is contraindicated with the use of the
absorbed. This process is known as: medication?

a. Hepatic clearance. a. Diabetes Mellitus

b. Total clearance. b. Angle-closure glaucoma
c. Enterohepatic cycling. c. Emphysema
d. First-pass effect. d. Urinary tract infection

An adult patient has been taking a drug A client is receiving methocarbamol

(Drug A) that is highly metabolized by the (Robaxin) as an adjunct to physical therapy
for the relief of painful muscle discomfort. Gold sodium thiomalate is prescribed to a
Which of the following is not true regarding client with rheumatoid arthritis. Which of
the use of the medication? the following side effects indicates an
overdose of the medication?
a. The parenteral form causes
hypotension and bradycardia when a. Flushing.
given rapidly. b. Dizziness.
b. The medicine can cause the urine to c. Joint pain.
turn brown, black, or green. d. Metallic taste.
c. The use of a cold or allergy medicine
Gold salt toxicity can be reversed using
will lessen the side effects of the
which medication?
medication.
d. The parenteral form is a. Acetaminophen.
contraindicated in clients with liver b. Dimercaprol.
damage. c. Calcium salts.
d. Hydroxocobalamine.
Allopurinol (Zyloprim) is prescribed for a
client for the treatment of gout. And the Adalimumab (Humira) is given to a client
nurse is providing medication instructions. for the treatment of rheumatoid arthritis.
The nurse tells the client to? Which of the following side effect is
associated with the medication?
a. Take the medication on an empty
stomach a. Numbness
b. To limit the use of vitamin C b. Constipation
c. A rash is a normal side effect of the c. Urinary retention
medication d. Weight gain
d. The effect of the medication will
happen immediately A client receiving azathioprine (Imuran)
complains of hair loss. The nurse tells the
A client is prescribed Colchicine. After client that?
taking three doses, the client complains of
nausea, vomiting, and loose bowel stools. a. Hair loss is irreversible
Which of the following should the client do? b. Hair loss is uncommon
c. Hair loss is temporary
a. Skip the next dose, and take the d. Hair loss is a sign of toxicity
another dose.
b. Withhold the medication and the The client is about to start the treatment for
physician is notified. juvenile rheumatoid arthritis. Before the
c. Continue taking the medication as administration of etanercept (Enbrel), it is
important for the nurse to:
these symptoms will go away.
d. Cut in half the next dosage. a. Ask for an allergy to latex.
Colchicine is prescribed for a client with b. Ask the client to postpone a vacation
gout. The nurse reviews the client’s record, trip abroad.
knowing that this medication would be used c. Tell the client to not miss due
in caution in which of the following medical vaccination while on treatment.
conditions? d. To avoid people with a recent
injection of etanercept.
a. Behcet disease
b. Aplastic Anemia A nurse is giving medicinal instructions to a
c. Amyloidosis female client receiving leflunomide (Arava).
d. Familial Mediterranean fever (FMF) Which of the following is an appropriate
instruction with the use of the medication?
A client taking probenecid is complaining of
gout pain. Which of the following a. To use an effective form of birth
medication should the nurse expect to be control while on the treatment.
administered? b. Breastfeeding does not have to be
stopped during the treatment.
a. acetaminophen (Tylenol) c. To use cholestyramine to lessen the
b. aspirin (Ecotrin) side effects.
c. orphenadrine (Norflex)
d. tizanidine (Zanaflex)
 d. It may take 3-5 days to notice any (Miacalcin) nasal spray. The nurse tells the
improvement while taking client to do the following, except?
leflunomide.
a. Delivery system contains enough
A client with rheumatoid arthritis has been medication for at least 30 doses.
receiving hydroxychloroquine (Plaquenil) in Discard any unused solution after 30
recent months. The nurse tells the client to doses.
visit which of the following while on the b. If you do not feel the spray while
treatment? using it, repeat the dose on the other
nostrils.
a. Dentist
c. Miacalcin is usually given as one
b. Ophthalmologist
spray per day into only one of your
c. Pulmonologist
nostrils.
d. Endocrinologist
d. Take extra vitamin D while you are
A client has just been prescribed with using Miacalcin.
methotrexate (Trexall) for the treatment of
rheumatoid arthritis who did not respond to
any other treatment. An important reminder PHARMACOLOGY EXAM 4
for the client is to?
Walter, a teenage patient is admitted to the
a. Clay-colored stool is a normal hospital because of acetaminophen (Tylenol)
response of the treatment. overdose. Overdoses of acetaminophen can
b. Pregnancy is not contraindicated precipitate life-threatening abnormalities in
with the use of the medication. which of the following organs?
c. Strict hand washing.
a. Lungs
d. Get a daily source of sunlight during
b. Liver
the day.
c. Kidney
A client who is taking Methotrexate d. Adrenal Glands
(Trexall) asks the nurse on what is the
A contraindication for topical corticosteroid
appropriate activity while taking the
usage in a male patient with atopic
medication. The nurse advised the client to
dermatitis (eczema) is:
play which activity?
a. Parasite infection.
a. Baketball
b. Viral infection.
b. Ice hockey
c. Bacterial infection.
c. Football
d. Spirochete infection.
d. Tennis
In infants and children, the side effects of
The nurse is reviewing the client’s history
first-generation over-the-counter (OTC)
who is about to take Methotrexate. Which of
antihistamines, such as diphenhydramine
the following drugs can be safely
(Benadryl) and hydroxyzine (Atarax)
administered together with methotrexate?
include:
a. Tetracycline
a. Reye’s syndrome.
b. Folic Acid
b. Cholinergic effects.
c. Sulfamethoxazole
c. Paradoxical CNS stimulation.
d. Phenytoin
d. Nausea and diarrhea.
Alendronate (Fosamax) is given to a client
Reye’s syndrome, a potentially fatal illness
with osteoporosis. The nurse advises the
associated with liver failure and
client to?
encephalopathy is associated with the
a. Take the medication in the morning administration of which over-the-counter
with meals. (OTC) medication?
b. Take the medication before bedtime.
a. acetaminophen (Tylenol)
c. Take the medication with a glass of
b. ibuprofen (Motrin)
water after rising in the morning.
c. aspirin
d. Take the medication during lunch.
d. brompheniramine/pseudoephedrine
A client with osteoporosis is asking the (Dimetapp)
nurse regarding the use of Salmon calcitonin
The nurse is aware that the patients who are d. Pyrexia.
allergic to intravenous contrast media are
Mandy, a patient, calls the clinic today
usually also allergic to which of the
because he is taking atorvastatin (Lipitor) to
following products?
treat his high cholesterol and is having pain
a. Eggs in both of his legs. You instruct him to:
b. Shellfish
a. Stop taking the drug and make an
c. Soy
appointment to be seen next week.
d. Acidic fruits
b. Continue taking the drug and make
A 13-month-old child recently arrived in the an appointment to be seen next week.
United States from a foreign country with c. Walk for at least 30 minutes and call
his parents and needs childhood if symptoms continue.
immunizations. His mother reports that he is d. Stop taking the drug and come to the
allergic to eggs. Upon further questioning, clinic to be seen today.
you determine that the allergy to eggs is
Which of the following adverse effects is
anaphylaxis. Which of the following
associated with levothyroxine (Synthroid)
vaccines should he not receive?
therapy?
a. Hepatitis B.
a. Hypotension.
b. inactivated polio.
b. Bradycardia.
c. diphtheria, acellular pertussis,
c. Tachycardia.
tetanus (DTaP).
d. Constipation.
d. mumps, measles, rubella (MMR).
Which of the following adverse effects is
The cell and Coombs classification system
specific to the biguanide diabetic drug
categorizes allergic reactions and is useful in
metformin (Glucophage) therapy?
describing and classifying patient reactions
to drugs. Type I reactions are immediate a. Hypoglycemia.
hypersensitivity reactions and are mediated b. Lactic acidosis.
by: c. GI distress
d. Somnolence.
a. immunoglobulin E (IgE).
b. immunoglobulin G (IgG). The most serious adverse effect of tricyclic
c. immunoglobulin A (IgA). antidepressant (TCA) overdose is:
d. immunoglobulin M (IgM).
a. Hyperpyrexia.
Drugs can cause adverse events in a patient. b. Cardiac arrhythmias.
Bone marrow toxicity is one of the most c. Seizures.
frequent types of drug-induced toxicity. d. Metabolic acidosis.
The most serious form of bone marrow
toxicity is: The nurse is aware that the following
solutions are routinely used to flush an IV
a. Aplastic anemia. device before and after the administration of
b. Thrombocytosis. blood to a patient is:
c. Leukocytosis.
d. Granulocytosis. a. 0.9 percent sodium chloride.
b. 5 percent dextrose in water solution.
Serious adverse effects of oral c. Sterile water.
contraceptives include: d. Heparin sodium.
a. Increase in skin oil followed by acne. Chris asks the nurse whether all donor blood
b. Headache and dizziness. products are cross-matched with the
c. Early or mid-cycle bleeding. recipient to prevent a transfusion reaction.
d. Thromboembolic complications. Which of the following always require
cross-matching?
The most serious adverse effect of
Alprostadil (Prostin VR pediatric injection) a. Granulocytes.
administration in neonates is: b. Platelets.
c. Plasma.
a. Bleeding tendencies.
d. Packed red blood cells
b. Apnea.
c. Hypotension.
A month after receiving a blood transfusion A severely immunocompromised female
an immunocompromised male patient patient requires a blood transfusion. To
develops a fever, liver abnormalities, a rash, prevent GVHD, the physician will order:
and diarrhea. The nurse would suspect this
a. diphenhydramine hydrochloride
patient has:
(Benadryl).
a. An allergic response to a recent b. The transfusion to be administered
medication. slowly over several hours.
b. Graft-versus-host disease (GVHD). c. Irradiation of the donor blood.
c. Myelosuppression. d. acetaminophen (Tylenol).
d. Nothing related to the blood
Louie who is to receive a blood transfusion
transfusion.
asks the nurse what is the most common
Jonas comes into the local blood donation type of infection he could receive from the
center. He says he is here to donate platelets transfusion. The nurse teaches him that
only today. The nurse knows this process is approximately 1 in 250,000 patients
called: contract:
a. Directed donation. a. Human immunodeficiency disease
b. Autologous donation. (HIV).
c. Apheresis. b. Hepatitis C infection.
d. Allogeneic donation. c. Hepatitis B infection.
d. West Nile viral disease.
Nurse Bryan knows that the age group that
uses the most units of blood and blood A male patient with blood type AB, Rh
products is: factor positive needs a blood transfusion.
The Transfusion Service (blood bank) sends
a. Premature infants.
type O, Rh factor negative blood to the unit
b. Children ages 1-20 years.
for the nurse to infuse into this patient. The
c. Adults ages 21-64 years.
nurse knows that:
d. The elderly above age 65 years.
a. This donor blood is incompatible
A child is admitted with a serious infection.
with the patient’s blood.
After two days of antibiotics, he is severely
b. Premedication the patient with
neutropenic. The physician orders
diphenhydramine hydrochloride
granulocyte transfusions for the next four
(Benadryl) and acetaminophen
days. The mother asks the nurse why? The
(Tylenol) will prevent any
nurse responds:
transfusion reactions or side effects.
a. “This is the only treatment left to c. This is a compatible match.
offer the child.” d. The patient is at minimal risk
b. “This therapy is fast and reliable in receiving this product since it is the
treating infections in children.” first time he has been transfused with
c. “The physician will have to explain type O, Rh negative blood.
his rationale to you.”
Dr. Rodriguez orders 250 milliliters of
d. “Granulocyte transfusions replenish
packed red blood cells (RBC) for a patient.
the low white blood cells until the
This therapy is administered for the
body can produce its own.”
treatment of:
A neighbor tells nurse Maureen he has to
a. Thrombocytopenia.
have surgery and is reluctant to have any
b. Leukopenia.
blood product transfusions because of a fear
c. Anemia.
of contracting an infection. He asks the
d. Hypoalbuminemia.
nurse what are his options. The nurse
teaches the person that the safest blood A female patient needs a whole blood
product is: transfusion. In order for transfusion services
(the blood bank) to prepare the correct
a. An allogeneic product.
product a sample of the patient’s blood must
b. A directed donation product.
be obtained for:
c. An autologous product.
d. A cross-matched product. a. A complete blood count and
differential.
 b. A blood type and crossmatch. d. To attempt to sterilize the catheter
c. A blood culture and sensitivity. and prevent having to remove it.
d. A blood type and antibody screen.
Chemotherapy dosing is usually based on
A male patient needs to receive a unit of the total body surface. What should the
whole blood. What type of intravenous (IV) nurse do before administering
device should the nurse consider starting? chemotherapy?
a. A small catheter to decrease patient a. Get the body mass index (BMI).
discomfort. b. Ask the client about intake and
b. The type of IV device the patient has output.
had in the past, which worked well. c. Weigh and measure the height of the
c. A large-bore catheter. patient on the day of administration.
d. The type of device the physician d. Ask the client for the height and
prefers. weight.
Dr. Smith orders a gram of human salt poor The nurse is caring for a client who is
albumin product for a patient. The product is receiving a chemotherapy. Which of the
available in a 50-milliliter vial with a following would be expected as a result of
concentration of 25 percent. What dosage the massive cell destruction that occurred
will the nurse administer? from the chemotherapy?
a. The nurse should use the entire 50- a. Leukopenia.
milliliter vial. b. Anemia.
b. The nurse should determine the c. Thrombocytopenia.
volume to administer from the d. Hyperuricemia.
physician.
Mitomycin (Mutamycin) is prescribed to a
c. This concentration of product should
client with colorectal cancer. All of which
not be used.
are the routes of administration, except?
d. The nurse will administer 4
milliliters. a. Oral.
b. Intravenous.
Central venous access devices (CVADs) are
c. Intravesical.
frequently utilized to administer
d. Intraarterial.
chemotherapy. What is a distinct advantage
of using the CVAD for chemotherapeutic The client with a testicular cancer is being
agent administration? treated with Etoposide (Etopophos). Which
of the following side effect is specifically
a. CVADs are less expensive than a
associated with this medication?
peripheral IV.
b. Once a week administration is a. Chest pain.
possible. b. Edema.
c. Caustic agents in small veins can be c. Alopecia.
avoided. d. Orthostatic hypotension.
d. The patient or his family can
administer the drug at home. The clinic nurse provides instructions to a
client receiving an antineoplastic
A female patient’s central venous access medication. When implementing the plan,
device (CVAD) becomes infected. Why the nurse tells the client to?
would the physician order antibiotics to be
given through the line rather than through a a. To consult with health care providers
peripheral IV line? before receiving immunization.
b. To avoid hot foods and high fiber-
a. To prevent infiltration of the rich foods.
peripheral line. c. To take acetylsalicylic acid as
b. To reduce the pain and discomfort needed for headache.
associated with antibiotic d. To drink beverages containing
administration in a small vein. alcohol in moderate amount during
c. To lessen the chance of an allergic the evening.
reaction to the antibiotic.
The client with non-Hodgkin’s lymphoma is
being managed with vincristine (Vincasar).
Which of the following indicates a side nurse reviews the client’s history and
effect specific to this medication? contacts the physician if which of the
following is documented in the client’s
a. Alopecia.
history?
b. Numbness in the toes.
c. Chest heaviness. a. Bronchial asthma.
d. Weight gain. b. Gouty arthritis.
c. Pulmonary embolism.
A client with sarcoma is receiving
d. Ischemic heart disease.
Bleomycin (Blenoxane). The nurse in charge
of the client expects the physician to order The client with non-Hodgkin’s lymphoma is
which diagnostic procedure? receiving Idarubicin (Idamycin). Which of
the following would indicate to the nurse
a. Pulmonary function studies (PFT's).
that the client is experiencing an adverse
b. Stress test.
effect related to the medication?
c. Cranial x-ray.
d. Electrocardiogram (ECG). a. Dysrhythmia.
b. Weight loss.
A male client with breast cancer is receiving
c. Nausea and vomiting.
Tamoxifen (Nolvadex). The nurse
d. Peripheral neuropathy.
specifically monitors which laboratory
value? The client is receiving cisplatin (Platinol-
AQ). Which of the following side effect is
a. Activated partial thromboplastin
related to the medication?
time.
b. Triglyceride level. a. Depressed tendon reflexes.
c. Fasting blood sugar. b. Photosensitivity.
d. Serum sodium and potassium. c. Tinnitus.
d. Ptosis.
The client with an ovarian cancer is
receiving Tamoxifen (Nolvadex). Which of The nurse is monitoring the laboratory
the following indicates a side effect specific results of a male client receiving
to this medication? antineoplastic medications. The nurse plans
to initiate bleeding precautions if which
a. Weak and brittle nails.
laboratory is value is noted?
b. Facial twitching.
c. Convulsions. a. White blood cell count of
d. Constipation. 6,000/mm3.
b. Platelet count of 45,000 cells/mm3.
The client with acute myelocytic leukemia is
c. Clotting time of 8 minutes.
being treated with busulfan (Myleran). The
d. Hemoglobin count of 15g/dl.
nurse specifically monitors which laboratory
value while the client is taking this A client is receiving methotrexate
medication? (Rheumatrex) for a series of chemotherapy.
Which of the following medication should
a. Serum calcium.
be readily available to avoid toxicity?
b. Uric acid level.
c. time. a. mesna (Mesnex).
d. Platelet count. b. vigabatrin (Sabril).
c. leucovorin (Folinic acid).
The nurse is evaluating the medical history
d. oseltamivir (Tamiflu).
of a client who will be receiving
Asparaginase (Elspar). The nurse contacts The nurse is providing teachings to a client
the health care provider if which of the receiving cyclophosphamide (Cytoxan). The
following is noted in the history? nurse tells the client to which of the
following?
a. Diabetes Mellitus type II.
b. Pancreatitis. a. Eat foods rich in potassium.
c. Asthma. b. Increase fluid intake to 2-3 liters per
d. Ischemic heart disease. day.
c. Take the medication with food.
Megestrol acetate (Megace) is prescribed for
d. Eat foods rich in purine.
a client with advanced breast cancer. The
The nurse is monitoring a patient receiving When two drugs given together have an
an Iv infusion of an antineoplastic effect equal to the sum of their respective
medication. During the infusion, the patient effects, the interaction is known as:
complains of pain and redness at the
a. Potentiated
insertion site. The nurse should take which
b. Antagonized
actions? Select all that apply.
c. Agonist
a. Reinsert the IV at a distal part of the d. Additive
same vein.
Absorption, distribution, and excretion may
b. Increase the flow rate of the
be increased by which of the following
medication.
diseases?
c. Notify the physician.
d. Apply a heat or ice compress to the a. Hyperthyroidism
site. b. Renal insufficiency
e. Administer an antidote as prescribed. c. Liver disease
d. Hypothyroidism
The nurse is caring for a client receiving
chemotherapy when an anaphylactic When a drug is 50% protein-bound, it means
reaction occurs from the medication. The that:
nurse should take which actions? Select all
that apply. a. 50% of the drug destroys protein.
b. 50% of the dose is at work.
a. Stop the medication. c. 50% of the drug is excreted in the
b. Remove the IV line. kidneys.
c. Administer Oxygen. d. Protein must be restricted in the diet.
d. Administer epinephrine.
e. Positioned the client in a reverse Safety of a drug is determined by the degree
Trendelenburg position. between:

The nurse is caring for a client who is a. Therapeutic and toxic doses.
receiving fluorouracil (Adrucil). Which of b. Potency and efficacy.
the following symptoms would necessitate c. Subtherapeutic and toxic levels.
the nurse to immediate discontinuation of d. Side and adverse effects.
the medication? When a drug binds to a receptor to produce a
a. Palmar-plantar erythrodysesthesia. pharmacologic effect, the drug may be
b. Ataxia. called a(n):
c. Constipation. a. Antagonist
d. Insomnia. b. Agonist
c. Blocker
d. Accelerator
PHARMACOLOGY EXAM 5
The extent to which drug is absorbed and
The name selected by the original transported to target tissue is known as:
manufacturer based on the chemical structure
of the drug is the: a. Steady-state accumulation
b. Therapeutic drug levels
a. Chemical name c. Bioavailability
b. Drug name d. Distribution
c. Generic name
d. Drug name Drug distribution is affected by which of the
following?
The interaction of one drug increased by the
presence of a second drug is known as: a. Biotransformation
b. Excretion
a. Potentiation c. Protein binding
b. Addictive effects d. Lipid binding
c. Antagonism
d. Synergism An unexpected effect of the drug is known
as a(n):
a. Side effect
b. Adverse effect
 c. Toxic reaction When performing an assessment to
d. Allergic reaction determine which medications can be used,
which of the following elements
As a knowledgeable nurse, you know that
is most important?
the following are part of the 10
rights except: a. Physical examination
b. Allergies
a. Right dose
c. Presence of illness
b. Right route
d. Weight
c. Right drug
d. Right room Central venous access devices are beneficial
in pediatric therapy because:
When performing an assessment about
medication, the drug history should include: a. They are difficult to see.
b. They cannot be dislodged.
a. Complete vital signs.
c. Use of the arms is not restricted.
b. Client's goal of therapy.
d. They don’t frighten children.
c. Reason for medication.
d. Administration of OTC medications. When considering the pharmacotherapeutic
effects of drugs administered to clients, the
The volume of SC medication must be no
nurse considers which property
more than:
of most importance:
a. 0.5 mL.
a. Efficacy.
b. 1.0 mL. b. Interaction with other drugs.
c. Potency
c. 1.5 mL. d. Toxicity
d. 3.0 mL. As a well-rounded health care provider, you
Which of the following muscles is a possible know that corticosteroid therapy is indicated
site for IM injections? in all of the following conditions except:

a. Outer aspect of the hip. a. Osteoarthritis

b. Shoulder. b. Rheumatoid arthritis
c. Vastus gluteus. c. Systemic lupus erythematosus
d. Vastus lateralis. d. Acute spinal cord injury

When deciding on what time of day to give Oral steroids are prescribed on a taper in
medications, the nurse pays the closest order to:
attention to the client’s habits regarding: a. Achieve optimal serum levels.
a. Eating b. Ensure drug reliability.
b. Sleeping c. Ensure compliance.
c. Elimination d. Prevent steroid withdrawal
d. Activity syndrome.

The client’s ability to take oral medications Orlando who has been taking steroids for
will be hindered by: rheumatoid arthritis over several years
presents with a compression vertebral
a. Age fracture. This fracture is due to:
b. Dental caries
c. Dysphagia a. An entirely separate condition.
d. Lifestyle b. The osteoporotic effect of long-term
steroid use.
Which of the following will determine c. Deterioration in rheumatoid arthritis.
nursing interventions for a client on d. An excessively high dose of steroids.
medication?
Tom is admitted to the emergency
a. Assessment department with an acute spinal cord injury.
b. Diagnosis Methylprednisolone is contraindicated for
c. Implementation treatment when the injury:
d. Evaluation
a. Is a high cervical lesion.
b. Occurred less than 4 hours ago.
 c. Occurred less than 8 hours ago. c. On an empty stomach.
d. Occurred more than 8 hours ago. d. With meals.
Which of the following statements about Which of the following NSAIDs is used to
intravenous administration of steroids is prevent thrombosis?
true?
a. ibuprofen (Motrin)
a. Steroids administered intravenously b. ketorolac tromethamine (Toradol)
must be diluted. c. aspirin (Zorprin)
b. Steroids administered intravenously d. naproxen (Naprosyn)
can be either in diluted or undiluted
Nurse Corrine may expect to administer
form.
azathioprine (Imuran) to a transplant client
c. Steroids should be given IV push
in which of the following conditions?
only.
d. Intravenous administration of a. Prevention of chronic rejection.
steroids is contraindicated in acutely b. Prevention of acute rejection.
ill clients. c. Management of chronic rejection.
d. Treatment of acute rejection.
An appropriate nursing diagnosis for clients
who are taking NSAIDs and anticoagulants Which of the following laboratory tests
would be which of the following? should be monitored when a client is
receiving azathioprine?
a. Risk for injury related to prolonged
bleeding time, inhibition of platelet a. CBC
aggregation, and increased risk of GI b. BUN
bleeding. c. Electrolytes
b. Potential for injury related to GI d. Sedimentation rate
toxicity and decrease in bleeding
time. In a transplant client, the action of
c. Altered protection related to GI cyclosporine is to:
bleeding and increasing platelet a. Defend the body against foreign
aggregation. antigens.
d. Risk for injury related to b. Inhibit T cells in response to
thrombocytosis prolonged antigens.
prothrombin time. c. Inhibit B cell immunoglobulin.
Teaching has been adequate when a client d. Intensify the production of T
being treated with acetylsalicylic acid states: lymphocytes.

a. "I can crush the pills before I A client who is taking mycophenolate
swallow them." mofetil must follow which of the following
b. "I should take the pills with instructions?
antacids." a. Take with food.
c. "Taking the pills on an empty b. Avoid use of corticosteroid.
stomach will help absorption." c. Monitor for adverse effects.
d. "If the pills smell like vinegar, I d. Practice effective contraception.
should throw them out."
Which of the following client comments
Which of the following groups of clients demonstrates that teaching has been
are most at risk for GI bleeding from the use successful regarding cyclosporine therapy?
of NSAIDs?
a. "I need to mix the medicine in
a. Clients with dysmenorrhea. Styrofoam."
b. Clients with headaches. b. "I should take the medication on an
c. Clients with arthritis. empty stomach."
d. Clients with renal failure. c. "If I vomit I should take another
To minimize the risk of dyspnea and GI dose."
bleeding, OTC ibuprofen is given: d. "I need to be consistent about when I
take it and also monitor how much
a. IV fat is in my food."
b. With orange juice.
Antirheumatics are used to: d. Hematocrit is lowered.
a. Retard progression of joint Which of the following is the priority
deterioration. nursing diagnosis for a client undergoing
b. Encourage excretion of chemotherapy?
autoantibodies.
a. Altered nutrition
c. Directly affect the inflammatory
b. Fear
response.
c. Decreased cardiac output
d. Mediate the action of NSAIDs.
d. Anxiety
Gold compounds are contraindicated in
Which of the following contributes most to
clients with:
the debilitation of an individual during a
a. Liver dysfunction course of chemotherapy?
b. Cardiac disease
a. Diarrhea
c. Preexisting dermatitis
b. Alopecia
d. Rheumatoid arthritis
c. Constipation
Which of the following agents can be used d. Pain
in the treatment of rheumatoid arthritis,
Combination chemotherapy is used in the
Sjögren’s syndrome, and SLE?
treatment of cancer because:
a. auranofin (Ridaura)
a. Single-agent therapy produces cell
b. allopurinol (Zyloprim)
lines that are resistant.
c. sulfasalazine (Azulfidine)
b. drugs are more likely to work.
d. chloroquine (Aralen)
c. Single-agent therapy requires larger
Frequent eye examinations are doses for long remissions.
recommended in clients receiving: d. Two cancers may be present.
a. Chloroquine A pregnant client is receiving magnesium
b. Colchicine sulfate therapy for the control of
c. Penicillamine preeclampsia. A nurse discovers that the
d. gold compounds client is encountering toxicity from the
medication in which of the following
Nurse Tyra is instructing a client receiving
assessments?
probenecid (Benemid), she should cover all
of the following information except the need a. Respirations of 10 breaths per
to: minute.
b. Presence of deep tendon reflex.
a. Change in dietary habits.
c. Urine output of 25 ml/hr.
b. Increase fluid intake.
d. Serum magnesium level of 7 mEq/L.
c. Have frequent laboratory work done.
d. Recognize side effects. A student nurse was asked by the nurse
instructor to explain the procedure for the
Enrique who is under chemotherapy has the
administration of erythromycin ointment to
following CBC results: WBC 5000/mm3,
the eyes of the newborn. Which of the
RBC platelet 10,000/mm3. Which of the
following statements made by the student
following is he at risk for?
indicates a need for further research?
a. Infection
a. "I will instill the eye ointment into
b. Bleeding
each of the newborn's conjunctival
c. Angina
sacs."
d. None of the above
b. "I need to administer the eye
Lorraine who is on chemotherapy has a ointment within an hour after
history of cardiac disease. The client is at maternal delivery."
risk for cardiac complications because: c. "I will clean the newborn's eyes
before instilling the ointment."
a. White blood cells are reduced.
d. "I will flush the newborn's eyes after
b. Oxygen-carrying capacity may be instilling the ointment."
reduced.
c. Sodium levels may rise meaning Rho(D) immune globulin (RhoGAM) is
fluid overload. given to a pregnant woman after delivery
and the nurse is giving information to the of the following assessments will concern
patient about the indication of the the nurse most?
medication. The nurse determines that the
a. Blood glucose level of 280 mg/dl.
patient understands the purpose of the
b. Daily weight gain of 0.5 kg.
medication if the patient tells that it will
c. Client no longer recognizes the
protect her baby from which of the
family member.
following?
d. Client still complains of headaches.
a. Developing Pernicious anemia.
A client who is receiving edrophonium
b. Developing German Measles.
chloride suddenly is complaining of
c. Having an RH+ blood.
abdominal cramps and the nurse observes
d. Developing Rh incompatibility.
the client is experiencing increased
A pregnant woman who is having labor perspiration and salivation. The nurse makes
pains is receiving an opioid analgesic. sure the availability of which of the
Which of the following medications should following?
be ready in case a respiratory depression
a. Levodopa
occurs?
b. methylphenidate hydrochloride
a. oxycodone (Oxycontin) (Ritalin)
b. naloxone (Narcan) c. atropine sulfate (Atropine)
c. meperidine hydrochloride (Demerol) d. carbamazepine (Tegretol)
d. morphine sulfate (Roxanol)
A nurse is instructing a client regarding
Methylergonovine (Methergine) is carbidopa-levodopa (Sinemet) for the
prescribed to a patient who is having treatment of Parkinson’s disease. The nurse
postpartum bleeding. Prior to giving the tells the client which of the following
medication, the nurse contacts the physician indicates an overdose of the medication?
who prescribed the medication if which of
a. Difficulty performing a voluntary
the following condition is documented in the
movement.
patient’s chart?
b. Increased blood pressure.
a. Hypotension c. Decreased appetite.
b. Uterine atony d. Black tarry stools.
c. Ischemic heart disease
A nurse is giving dietary instructions to a
d. Acute Gastroenteritis
client receiving levodopa. Which of the
following food items should be avoided by
the client?
PHARMACOLOGY EXAM 6
a. Goat yogurt
A client with myasthenia gravis frequently
b. Whole grain cereal
complains of weakness and fatigue. The
c. Asparagus
physician plans to identify whether the client
d. Apples
is responding to an overdose of the
medication or a worsening of the disease. A Biperiden hydrochloride (Akineton) is added
tensilon test is performed. Which of the to a list of antiparkinsonian medications that
following would indicate that the client is an elderly client is taking. Which of the
experiencing an overdose of the medication? following instructions made by the nurse
that needs further learning?
a. Temporarily worsening of the
condition. a. Avoiding alcohol and caffeine.
b. Improvement of weakness and b. Using ice chips, candy or gum for
fatigue. dry mouth.
c. No change in the condition. c. Walking in the morning to have a
d. Complaints of muscle spasms. daily source of direct sunlight.
d. Eating foods rich in fiber and
A client with juvenile pilocytic astrocytoma
increase fluid intake.
who is receiving dexamethasone (Decadron)
4mg/IV every 6 hours to relieve symptoms
of right arm weakness and headache. Which
The nurse is giving instructions to a client c. 45-65 mcg/ml
receiving phenytoin (Dilantin). The nurse d. 50-90 mcg/ml
concludes that the client has a sufficient
A child was brought to the emergency room
knowledge if the client states that:
complaining of right upper quadrant
a. "Wearing a medical alert tag is not abdominal pain, nausea, and vomiting. Upon
required". the interview of the nurse to the mother, the
b. "Alcohol is permitted while taking client has been taking a long-term use of
this medication". acetaminophen. Overdosage of the
c. "I can take the medicine with milk". medication is suspected. Which of the
d. "Have the serum phenytoin level following medications should be readily
taken before giving the medication". available?
A 17-year-old client is taking phenytoin a. naltrexone (ReVia)
(Dilantin) for the treatment of seizures.
b. urea (Ureaphil)
Phenytoin blood level reveals to be 25
mcg/ml. Which of the following symptoms c. acetylcysteine (Mucomyst)
would be expected as a result of the
laboratory result? d. valproic acid (Depakene)

a. No symptoms, because the value is A client with bell’s palsy tells the nurse that
within the normal range. acetaminophen (Tylenol) is taken daily as
b. Hyperactivity. prescribed by the physician. Which
c. Tremors. laboratory value would indicate a toxicity of
d. Nystagmus. the medication?

A client is prescribed with carbamazepine a. Blood urea nitrogen of 60 mg/dl.

(Tegretol) for the treatment of bipolar b. Total bilirubin of 1.5 mg/dl.
disorder. Which of the following laboratory c. Alkaline phosphatase of 120 IU/L.
results indicates that the client is d. Direct bilirubin of 0.3 mg/dl.
experiencing a side effect of this A nurse is caring for a client with a history
medication? of overdosage of aspirin. The nurse suspects
a. Neutrophil count of 1,200/mm3. which of the following can be an early sign
b. Platelet count of 160,000/mm3. of aspirin toxicity?
c. Uric acid level of 4mg/dl. a. Unsteady gait
d. SGPT (ALT) level 50 units per liter b. Drowsiness
of serum. c. Confusion
A female client who has a history of seizures d. Tinnitus
went to a healthcare facility to ask the nurse Meperidine hydrochloride (Demerol) is
regarding the use of birth control pills while given to a client who is experiencing post-
on phenytoin therapy. The nurse correctly operative pain. Which of the following are
states to the client that: the side effects of the medication, except?
a. Taking phenytoin decreases the a. Tremors
effectiveness of birth control pills. b. Diarrhea
b. Pregnancy is not allowed while c. Sweating
taking phenytoin. d. Dizziness
c. There is no known interaction
between these medicines so there is Codeine sulfate is prescribed to a client with
nothing to worry about. a severe back pain. Which of the following
d. To discontinue phenytoin and side effect is associated with this
proceed with the oral contraceptive. medication?

Phenobarbital (luminal) is given to a client a. Hypertension

for a short treatment of anxiety. Which of b. Urinary frequency
the following results would indicate a c. Constipation
therapeutic serum range of the medication? d. Hyperactivity

a. 5-10 mcg/ml
b. 15-40 mcg/ml
Mannitol (Osmitrol), an osmotic diuretic, is c. Viral load test
contraindicated to which conditions? Select d. White blood cell count
all that apply.
A client with acquired immunodeficiency
a. Pulmonary edema syndrome is prescribed with zidovudine
b. Narrow-angle glaucoma (Azidothymidine). Which of the following
c. Heart failure laboratory results should the nurse monitor
d. Chemotherapy while on this medication?
e. Hyponatremia
a. Throat swab gram stain.
A client with tonic-clonic seizure is b. Complete blood count
receiving phenobarbital (Luminal) and c. Random blood sugar
valproic acid (Depakene). The nurse tells the d. Blood uric acid
client that:
The client who is human immunodeficiency
a. Valproic acid decreases virus seropositive has been taking saquinavir
phenobarbital metabolism. (Invirase). The nurse provides medication
b. Valproic acid increases instructions and advises the client to:
phenobarbital metabolism.
a. Take the medication in the morning
c. There is no interaction between the
before meals.
two.
b. Include a low-fat diet.
d. Increase the dosage of the two
c. Weight gain is expected.
medications.
d. Avoid being exposed to sunlight.
A nurse is providing instructions to a client
Stavudine (Zerit) is prescribed to a client
who is taking doxapram (Dopram). Which
with human immunodeficiency virus
of the following statements made by the
seropositive. The nurse observes which of
client needs further instructions?
the following most closely while the client is
a. "I need to take the medication before taking the medication?
meals".
a. Orientation
b. "I need to take the medication at
b. Gag reflex
bedtime".
c. Appetite
c. "I need to avoid drinking coffee".
d. Gait
d. "I will not chew or crush long acting
form of the medications". A nurse is evaluating a client who is HIV
positive who is prescribed with pentamidine
Diazepam (Valium) is prescribed to a client
(Pentam) IV for the treatment of
with alcohol withdrawal. Which of the
Pneumocystis carinii pneumonia. Which of
following statements made by the client
the following assessment after the
indicates an understanding of the treatment
administration is the most important to relay
regimen?
to the physician?
a. "This medication causes a blurring
a. Blood pressure of 100/62 mm/Hg.
of vision".
b. Redness and pain at the site of the
b. "This medication will cause a
infusion.
decreased platelet and white blood
c. Sudden sweating and hunger.
cell count in my blood".
d. Unusual taste or dryness in the
c. "I'll have my physician lower my
mouth.
dosage once I start to feel okay".
d. "Drinking grapefruit can decrease the A client is prescribed with Pentamidine
side effects with this medication". (Pentam) IV for the treatment of
Pneumocystis carinii pneumonia. Suddenly,
An HIV-positive client who has been started
the client develops a temperature of 101.5°F.
on highly active antiretroviral therapy
The nurse in charge knows that this sign
(HAART) came back for a follow-up
would mostly indicate which of the
checkup. Which of the following will be
following?
the most helpful in determining the response
to the therapy? a. An overdosage of the medication.
b. The need for an additional dosage.
a. Rapid HIV antigen test
b. Western Blot analysis
 c. The client has developed another laboratory test during the treatment with this
infection. medication, except?
d. The client is experiencing the
a. Serum creatinine.
therapeutic effect of the medication.
b. Serum calcium.
While on pentamidine (Pentam) infusion c. Serum magnesium.
therapy. The nurse must anticipate doing d. Serum sodium.
which of the following?
A client is recently diagnosed with HIV and
a. Secure a 12-lead ECG. highly antiretroviral therapy is started. After
b. Observe for signs of retinal damage. the first week of therapy, the patient
c. Instruct the client on a low potassium complains of headaches, dizziness, and
diet. nightmares. Which one of the following
d. Instruct the client on limiting fluid antiretroviral drugs is most likely associated
intake. with these symptoms?
The nurse is monitoring a post-renal a. Lamivudine
transplantation client taking cyclosporine b. Efavirenz
(Neoral). The nurse observes an elevation in c. Tenofovir
one of the client’s vital signs and the client d. Saquinavir
is complaining of sweating and headache.
Sirolimus (Rapamune) is prescribed to a
Which of the following vital signs
post-renal transplantation client. Upon the
is most likely increased?
review of the chart, the nurse expects which
a. Respiratory rate of the following laboratory results?
b. Pulse rate
a. Elevated serum potassium
c. Temperature
b. Decreased cholesterol level
d. Blood pressure
c. Elevated platelet count
A nurse is doing an assessment data while d. Elevated triglyceride level
completing an admission for a patient with a
A post-kidney transplant client went to the
history of liver transplant who is receiving
health care facility to ask the nurse regarding
cyclosporine (Sandimmune), prednisone
vaccinations while on tacrolimus (Prograf) a
(Orasone), and azathioprine (Imuran).
medication used to prevent organ rejection.
Which of the following information will
Which of the following is an appropriate
give the nurse the most attention?
response of the nurse?
a. The client has a soft non-tender lump
a. "Do not skip due doses of
in the shoulder.
vaccination for this can help in your
b. An increased cholesterol level.
treatment".
c. Grade 1+ pitting edema in the feet.
b. "You can have live vaccinations
d. Swollen and pinkish gums noted.
even without the approval of the
A client is admitted to the emergency room physician".
complaining of difficulty of breathing and c. "Influenza can happen anytime, so a
upon auscultation, the nurse noted that the flu vaccine is a must."
patient has wheezes. An allergic reaction to d. "Do not receive any live vaccinations
penicillin was diagnosed. Which of the while on this treatment".
following medications should the nurse
A nurse is giving instructions to a client who
expect to administer first?
is receiving mycophenolate mofetil
a. aminophylline (Theophylline) (CellCept) and mycophenolic acid
b. albuterol (Ventolin HFA) (Myfortic) after undergoing a heart
c. methylprednisolone (Solu-Medrol) transplant. The nurse tells the client to
d. pulmicort (Budesonide) anticipate the following side effects, except?
The nurse is assigned to care for a client a. Hypersomnia
with cytomegalovirus retinitis and acquired b. Vomiting
immunodeficiency syndrome who is c. Hypertension
receiving foscarnet (Foscavir). The nurse d. Diarrhea
carefully monitors which of the following
Amikacin (Amikin) is given to a client with A nurse instructor is about to administer a
E-coli infection. The nurse advises the client vitamin K injection to a newborn. The
to report which of the following student nurse asks the instructor regarding
symptoms immediately? the purpose of the injection. The appropriate
response would be:
a. Muscle pain
b. Constipation a. "The vitamin K will protect the
c. Fatigue newborn from bleeding."
d. Hearing loss b. "The vitamin K will prevent the
occurrence of hyperbilirubinemia."
A client went to the emergency room with
c. "The vitamin K provides active
complaints of abdominal pain, nausea,
immunity."
diarrhea, and mucoid stools. Upon the
d. "The vitamin K will serve as
interview with the nurse, the client stated
protection against jaundice and
that he is taking cefixime (Suprax) for the
anemia."
treatment of urinary tract infection. The
nurse determines that the client A nurse is assigned to a patient who is
is most likely suffering from? receiving oxytocin (Pitocin) to induce labor.
The nurse terminates the oxycontin infusion
a. Crohn's disease
if which of the following is noted on the
b. Acute Gastroenteritis
assessment of the client?
c. Acute appendicitis
d. Pseudomembranous colitis a. Nausea
b. Fatigue
Amphotericin B (Fungizone) IV is given to a
c. Early decelerations of the fetal heart
client with aspergillosis, a fungal infection.
rate
In order to prevent its side effects, the nurse
d. Uterine hyperstimulation
anticipates administering which of the
following prior, except? A client in preterm labor (32 weeks) who is
dilated to 5cm has been given magnesium
a. Hydrocortisone
sulfate and the contractions have stopped. If
b. Ketoconazole
the labor can be delayed for the next 2 days,
c. Diphenhydramine
which of the following medication does the
d. Meperidine
nurse expect that will be prescribed?
A nurse is giving instructions to a client
a. fentanyl (Sublimaze)
taking ciprofloxacin (Cipro) for the
b. sufentanil (Sufenta)
treatment of gonorrhea. The nurse tells the
c. betamethasone (Celestone)
client to?
d. butorphanol tartrate (Stadol)
a. Report any history of tendon
Which of the following laboratory tests must
problems.
be monitored for pregnant patients receiving
b. Resume daily exercise such as
dexamethasone?
biking.
c. Take an antacid 30 minutes prior. a. Random blood sugar
d. Take it with a yogurt as part of the b. Serum calcium
treatment. c. Red blood cell count
d. Uric acid
Tetracycline has been prescribed for a client
with Chlamydia trachomatis infection. Patellar reflex is being monitored for
Select the side effect of the patients receiving magnesium sulfate
medication. Select all that apply. therapy. When assessing the deep tendon
reflex, which of the following grades
a. Glossitis
pertains to diminished response?
b. Tremors
a. Grade 0
c. Urinary frequency b. Grade 1
c. Grade 2
d. Discoloration of the nails d. Grade 4
e. Photosensitivity Prior giving of methylergonovine
(Methergine), what is the priority
assessment for the nurse to check which of e. Increase the flow rate of the
the following? intravenous additive solution.
a. Deep tendon reflexes
b. Urine output
c. Vaginal bleeding
d. Blood pressure
A nurse is preparing to give a lung
surfactant to a 36 weeks old baby with
respiratory distress syndrome. Which of the
following is the correct route of
administration?
a. Intradermal
b. Intratracheal
c. Intramuscular
d. Intravenous
A nurse is preparing to administer a Rubella
vaccine to a client prior to home discharge.
Which of the following is not true regarding
this vaccine?
a. Pain, redness, swelling, or a lump are
some of the adverse reactions.
b. Given intramuscularly in the lateral
aspect of the middle third of the
vastus lateralis muscle.
c. The need to use contraception after
immunization.
d. Contraindicated in a client with an
allergy to duck eggs.
A nurse is preparing dinoprostone (Cervidil)
for a client to induce labor. Which of the
following nursing intervention must be
questioned?
a. Have the client hold void before
administration.
b. Place the client in a side-lying
position for 30 to 60 minutes after
the administration.
c. Monitor maternal vital signs.
d. Have the client void before
administration.
A nurse caring for a patient receiving
oxytocin therapy suddenly is experiencing
hypertonic contractions. Which of the
following priority nursing actions should the
nurse do? Select all that apply.
a. The nurse leaves the client to ask for
help.
b. Administer oxygen at 8 to 10 liters
per minute.
c. Stop the oxytocin infusion.
d. Place the client in the supine
position.