HES 005 -PHARMACOLOGY- P1 EXAM

Total points50/50

1. Patient X has genital herpes and is using antiviral creams for her condition. Which
of the following is a potential side effect ofthe medication?
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a. Vulvitis

b. Headache
c. Dizziness
d. Staining of the skin

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ANSWER A.
Vulvitis. Antiviral creams can cause vulvitis when applied to the genitalia to treat genital herpes.

2. A 15 y/o patient came in for a severe case of respiratory flu and would need drug
therapy. Which of the following drugs shouldthe nurse anticipate to be prescribed?
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a. Acyclovir (Zovirax)
b. Amantadine (Symmetrel)

c. Abacavir (Ziagen)
d. Ganciclovir (Cytovene)
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ANSWER B.
Amantadine (Symmetrel).It is indicated for respiratory viruses. Options A and D are for herpes
viruses and CMV. Option C is an
NRTI and is indicated for HIV and AIDS.

3. Which of the following antiviral agents is effective as treatment for H1N1?

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a. Zidovudine
b. Acyclovir
c. Oseltamivir
d. Selzentry

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Answer: C.
Oseltamivir. It is the only antiviral agent effective for H1N1 and avian flu. Option A is the only
antiviral agent allowed for use in
pregnant women. Option B is the drug of choice for herpes and CMV infections in children.Lastly,
option D is a brand name of
maraviroc, a CCR5 coreceptor antagonist of HIV virus

4. Which of the following physical assessment findings will alert the nurse for
anthelmintic drug toxicity in elderly patients?
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a. Muscle strength +2
b. Blunt liver edge upon palpation

c. 10 bowel sounds in one minute on right lower quadrant (RLQ) upon auscultation
d. Non-palpable spleen

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ANSWER B.
Blunt liver edge upon palpation. This may indicate hepatomegaly or ongoing inflammatory process
which is adversely caused by
anthelmintics. All other options are normal PE findings.

5. The only protease inhibitor that is not teratogenic.

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a. Darunavir
b. Indinavir
c. Fosamprenavir
d. Saquinavir

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ANSWER D.
Saquinavir. However, this drug can cross into breast milk.

6.A senior nurse would be correct to advise her colleague to monitor which parameter
in patients receiving cyclosporine andzidovudine at the same time?
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a. Skin lesion, temperature, and color

b. Flu-like symptoms
c. Level of consciousness

d. CBC with differential count

7. Chemotherapy dosing is usually based on the total body surface. What should the
nurse do before administeringchemotherapy?
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a. Get the body mass index (BMI).

b. Ask the client about intake and output.
c. Weigh and measure the height of the patient on the day of administration.

d. Ask the client for the height and weight.

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LETTER C.To assure that the client obtains optimal doses of chemotherapy, dosing is usually based
on the total body surface (BSA),
which requires an accurate current measurement of height and weight on the day of the
administration. Options A and
B will not provide the information needed. Option D will lead to inaccurate value in determining the
true body total
surface.

8.The nurse is caring for of a client who is receiving a chemotherapy. Which of the
following would be expected as a resultof the massive cell destruction that occurred
from the chemotherapy?
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a. Leukopenia.
b. Anemia.
c. Thrombocytopenia.
d. Hyperuricemia.

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ANSWER D.
Increase level of uric acid (Hyperuricemia) in the body is common following the treatment for
leukemias and lymphomas
because chemotherapy results in massive cell destruction. Options A, B, and C are usually noted,
but an increase uric
acid level is specifically related to massive cell destruction.
9. Mitomycin (Mutamycin) is prescribed to a client with colorectal cancer. All of which
are the routes of administration,except?
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a. Oral

b. Intravenous
c. Intravesical
d. Intraarterial
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ANSWER A.
Mitomycin (Mutamycin) is an antitumor antibiotic used in the treatment of anal, bladder, breast,
cervical, colorectal, head
and neck, and non-small cell lung cancer. There is no pill form of this medication. Options B, C, and
D are the routes of
medication.

10.The client with a testicular cancer is being treated with Etoposide (Etopophos).
Which of the following side effect isspecifically associated with this medication?
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a. Chest pain
b. Edema
c. Alopecia
d. Orthostatic hypotension

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ANSWER D.
While on etoposide infusion, blood pressure is monitored throughout and it should be administered
slowly over 30-60
minutes to avoid hypotension. Options A and B are not related to this medication.Option C: Alopecia
happens nearly
with all the neoplastic medications.

11.A nurse is providing instructions to a client is taking Doxapram (Dopram). Which of

the following statements made bythe client needs further instructions?
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A. “I need to take the medication before meals”.

B. “I need to take the medication at bedtime”.

C. “I need to avoid drinking coffee“.

D. “I will not chew or crush long acting form of the medications”.
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ANSWER B.
“I need to take the medicaton at bedtime”.Doxapram (Dopram) is a central nervous system stimulant.
One of the side
effects is insomnia so instruct the client to take it at least 6 hours before bedtime to prevent it.

12. Narcolepsy can be best explained as:

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A. A sudden muscle weakness during exercise

B. Stopping breathing for short intervals during sleep
C. Frequent awakenings during the night
D. An overwhelming wave of sleepiness and falling asleep

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ANSWER D.
An overwhelming wave of sleepiness and falling asleep. Narcolepsy is a dysfunction of mechanisms
that regulate the sleep
and wake states. Excessive daytime sleepiness is the most common complaint associated with this
disorder. During the
day a person may suddenly feel an overwhelming wave of sleepiness and fall asleep; REM sleep
can occur within 15
minutes of falling asleep.

13.Older adults who take long-acting sedatives or hypnotics are likely to experience:
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A. Hallucinations
B. Ataxia

C. Alertness
D. Dyspnea

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ANSWER B. Ataxia. If longer-acting barbiturates are used in older adults, these clients may
experience daytime sedation,
ataxia, and memory deficits.

14. Which nursing diagnosis is appropriate for a patient who has received a sedative-
hypnotic agent?
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A. Alteration in tissue perfusion

B. Fluid volume excess
C. Risk for injury

D. Risk for infection

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ANSWER C. Risk for injury. Sedative-hypnotics cause CNS depression, putting the patient at risk for
injury.

15. A patient is admitted to the emergency department with an overdose of a

barbiturate. The nurse immediately preparesto administer which of the following from
the emergency drug cart?
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A. Naloxone HCl (Narcan

B. Activated charcoal

C. Flumazenil (Romazicon)
D. Ipecac syrup

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ANSWER B.
Activated charcoal. There is no antidote for barbiturates. The use of activated charcoal absorbs any
drug in the GI tract,
preventing absorption.

16.The nursery nurse is putting erythromycin ointment in the newborn’s eyes to

prevent infection. She places it in thefollowing area of the eye:
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a. Under the eyelid

b. On the cornea.
c. In the lower conjunctival sac

d. By the optic disc.

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ANSWER C.
The ointment is placed in the lower conjunctival sac so it will not scratch the eye itself and will get
well distributed.

17. Nursing responsibilities in the assessment phase of the nursing process include
which responsibilities? (Select all thatapply.)
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a. Identify side effects of drugs that are nonspecific

b. Check peak and trough levels of drugs

c. Advise client to avoid fatty foods prior to ingesting an enteric coated tablet
d. Evaluate client's reaction to drug

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ANSWER: A & B.
Identify side effects of drugs that are nonspecific & Check peak and trough levels of drugs

18. The nurse is aware of the many factors related to effective health teaching about
the medication. The most essentialcomponent of the teaching plan is to do which?
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a. Provide written instructions

b. Establish a trust relationship.

c. Use colorful charts.

d. Review community resources.

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ANSWER B.
Establish a trust relationship. A person can listen to or associate much better with someone like
themselves. In healthcare,
the nurse spends the most time with the patient, so a positive relationship has a great impact on the
patient's experience
and sets the tone for overall satisfaction. It is vital for nurses to build trust with our patients.

19. A medication health teaching plan is tailored to a specific client. Common topics
for health teaching include which?(Select all that apply.)
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a. Importance of adherence to the prescribed regimen

b. How to administer medication (s)

c. What side/adverse effects to report to the health care provider

d. Instruction of the client on what foods should be eaten

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ANSWER A,B & C.
It's easy for patients to make significant mistakes with their medications. We know this because
statistics show that every
minute, around three Americans call a poison control center because they have done just that.
Furthermore, data shows
that the rate of serious mistakes is on the rise, with many errors leading to a hospital stay. While
mistakes are inevitable,
nurses can help reduce their likelihood. That's where the importance of medication education for
patients comes in.

20. The nurse educator on the unit receives a list of high-alert drugs. Which strategies
are recommended to decrease therisk of errors with these medication? (Select all that
apply.)
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a. Store medications alphabetically on their usual shelf.

b. Limit access to these drugs.

c. Use special labels.

d. Provide increased information to staff.

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ANSWER B,C,D
Multiple strategies exist to decrease and mitigate errors in giving medications. Strategies include
limiting access
to the drugs, using special labels and providing education.

21 Nurse is preparing to administer a medication to a 13-year-old client. The nurse

follows the six rights of medicationadministration for a pediatric client. After checking
for the right client, the right dose, the right drug, the right time and theright route, what
is the final item the nurse must check for this client?
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a. Right age

b. Right Label
c. Right Documentation
d. Right strength

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ANSWER A.
The right documentation
The six rights of documentation are guidelines for healthcare providers to follow to best avoid
medication errors when
administering drugs. This is particularly important among children, who can suffer from life-
threatening complications if an
incorrect drug or dose is administered. The six rights of medication administration are the right
patient, the right dose, the
right drug, the right time, the right route, and the right documentation.

22. When performing an assessment about medication, the drug history should
include:
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a. Complete vital signs

b. Client’s goal of therapy
c. Reason for medication
d. Administration of OTC medications

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ANSWER D.
Administration of OTC medications. The nurse should determine if the client is taking any other
medications, especially
OTC medications because their effects are often minimized. Other choices are important part of
assessment, but choice D
is the most accurate answer.

23.The volume of SC medication must be no more than:

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a. 0.5 mL
b. 1.0 mL

c. 1.5 mL
d. 3.0 mL

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ANSWER B.
1.0 mL. The maximum amount of fluid that can be injected into the SC space is 1.0 mL.

24.Which of the following muscles is a possible site for IM injections?

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a. Outer aspect of the hip

b. Shoulder
c. Vastus gluteus
d. Vastus lateralis

25 Doctor’s Order: Tylenol supp 1 g pr q 6 hr prn temp > 101; Available: Tylenol supp
325 mg (scored). How many suppwill you administer?
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a. 2 supp
b. 1 supp
c. 3 supp

d. 5 supp
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Answer: C. 3 supp
1 g = 1000 mg

26. Doctor’s Order: Nafcillin 500 mg po pc; Available: Nafcillin 1 gm tab (scored). How
many tab will you administer perday?
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a. 2.5 tabs
b. 2 tabs
c. 1.5 tabs

d. 1 tab
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ANSWER C 1.5 tabs

1 g = 1,000 mg

27. Doctor’s Order: Synthroid 75 mcg po daily; Available: Synthroid 0.15 mg tab
(scored). How many tab will youadminister?
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a. 1 tab
b. 0.5 tab

c. 2 tabs
d. 1.5 tabs

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ANSWER B. 0.5 tab
1 mg = 1,000 mcg

28. Doctor’s Order: Diuril 1.8 mg/kg po tid; Available: Diuril 12.5 mg caps. How many
cap will you administer for eachdose to a 31 lb child?
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a. 2 caps

b. 2.5 caps
c. 3 caps
d. 1.5 caps

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ANSWER A. 2 caps
31 lbs = 14 kg

29. Doctor’s Order: Cleocin Oral Susp 600 mg po qid; Directions for mixing: Add 100
mL of water and shake vigorously.Each 2.5 mL will contain 100 mg of Cleocin. How
many tsp of Cleocin will you administer?
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a. 3 tsp

b. 5 tsp
c. 3.5 tsp
d. 1 tsp

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ANSWER A. 3 tsp

30.The nurse is administering an anti-infective that is considered to be a bacteriocidal.

Before beginning therapy, thenurse should assess the client for:
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a. Any neurologic abnormalities.

b. Cardiac history.
c. Hypersensitivity.

d. Respiratory conditions.

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ANSWER C.
Hypesensitivity. The role of the nurse in drug therapy with penicillin involves careful history taking to
assess for previous
reactions to penicillin.

31.Is determined by its chemical structure...sometimes a code name is assigned to the

drug and is often used in place of the chemical name because it is easier to write and
speak the code name rather than the chemical structure
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a. Chemical Name

b.Pharmacokinetics
c.Schedule IV
d.Absorption
e.Efficacy

32, Is the maximum intensity of effect or response that can be produced by a drug.
Related to the maximal effect of a drug, regardless of dose. The efficacy and potency
of a drug are unrelated
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a.Chemical Name
b.Pharmacokinetics
c.Schedule IV
d.Absorption
e.Efficacy

33.The study of how a drug enters the body, circulates within the body, is changed by
the body and leaves the body. The factors that influence the movement of a drug are
divided into 4 steps: Absorption, Distribution, Metabolism, and Excretion
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a. Chemical Name
b.Pharmacokinetics

c.Schedule IV
d.Absorption
e.Efficacy
34.The process where drug molecules are transferred from the site of administration
to the circulating blood
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a.Chemical Name
b.Pharmacokinetics
c.Schedule IV
d.Absorption

e.Efficacy

35.A drug is absorbed from its site of administration , is distributed to its site of action
via blood plasma. The biologic activity of the drug is related to the concentration of
free drug. Drugs bind to proteins & act as storage sites.
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a. Distribution by plasma

b. enterohepatic circulation
c. Distribution
d. noncompetitive antagonist

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A drug is absorbed from its site of administration , is distributed to its site of action via blood plasma.
The biologic activity of the drug is related to the concentration of free drug. Drugs bind to proteins &
act as storage sites.

36.Safest, least expensive & convenient route. May cause nausea & vomiting
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a. oral ( enteral )

b. local ( chemical signaling )

c. competitive antagonist
d. active to inactive

37.Advise the pregnant woman that any medication may have possible effects on the
baby.Weigh the actual benefits against the potential risks.Discuss with pregnant
women that they should not take medications without checking with their health care
provider first.
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A.Dermatological Reactions
B.Neurological Effects
C.Toxicity-Liver
D.Neurological Effects (cont.)
E.Teaching to prevent teratogenicity

38.General Central Nervous System (CNS) EffectsAssessment Findings: Altered level

of consciousnessInterventions: Prevent injury
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A,Dermatological Reactions
B.Neurological Effects

C.Toxicity-Liver
D.Teaching to prevent teratogenicit

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LETTER B.

39.Rash/HivesInterventionsMay need to discontinue the medication

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A.Dermatological Reactions

B.Neurological Effects
C.Toxicity-Liver
D.Neurological Effects (cont.)
E.Teaching to prevent teratogenicity

40,Hypokalemia Hyperkalemia
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a. Teratogenecity
b.adverse drug reaction
c.dermatological reaction
d.electrolyte imbalance

41.An 80-year-old patient presents at the clinic for a follow-up appointment. She is
taking a macrolide antibiotic and is experiencing tinnitus. The nurse is talking with
family members about home care for the patient. What should the nurse include in her
instructions regarding home care?
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Ephedrine breaks down stored glycogen, which then enters the bloodstream as glucose and
causes an increase in serum blood glucose, or blood sugar, levels. Ephedrine is not mixed with
sugar and is not a placebo. Ephedrine has no effect on insulin.
Macrolide antibiotics can cause severe auditory nerve damage, which can cause dizziness,
ringing in the ears (tinnitus), and loss of balance and hearing. The patient would be at high risk
for injury due to falls. Usually a person who is dizzy is unable to lie flat and needs to recline with
the head elevated. Salt and sunlight are not a component of this patient's presenting complaint.

Primary action adverse effects are extensions of the therapeutic action and are usually the result
of overdosage, essentially too much of the therapeutic effect. Anaphylaxis is not an extension of
the therapeutic action of the drug but a histamine reaction to an allergen. Secondary actions of a
drug are negative effects of the drug that occur even when the drug is in the therapeutic range.
Anticholinergic responses occur in response to drugs that block the parasympathetic nervous
system.
Chloroquine (Aralen) can cause ocular toxicity with blurring of vision, color vision changes,
corneal damage, and blindness. Increased urination, tingling, and numbness are signs of
hyperkalemia and hypokalemia. Loss of balance can be caused by auditory damage due to drug
toxicity.

42.The study of genetically determined variations in the response to drugs

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A.Pharmcogenomics

B.Drug-Food Interactions
C.Glomerular Filtration
D.Receptor Sites
E.Critical concentration

43.Specific areas on cell membranes that react with certain chemicals to cause an
effect within the cell
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A.Pharmcogenomics
B.Drug-Food Interactions
C.Glomerular Filtration
D.Receptor Sites

E.Critical concentratio

44.Certain foods interact with drugsDrugs are best taken on an empty stomach
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A.Pharmcogenomics
B.Drug-Food Interactions

C.Glomerular Filtration
D.Receptor Sites
E.Critical concentration

45.The concentration a drug must reach in the tissues that respond to the particular
drug to cause the desired therapeutic effect.
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A.Pharmcogenomics
B.Drug-Food Interactions
C.Glomerular Filtration
D.Receptor Sites
E.Critical concentration

46.The passage of water and water-soluble components from the plasma into the
renal tubule
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A.Pharmcogenomics
B.Drug-Food Interactions
C.Glomerular Filtration

D.Receptor Sites
E.Critical concentration

47.People will google and self-medicate. Make sure you know what they're taking and
where they're getting their info
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A.Administering drugs
B.The internet

C.Generic drugs
D.Abdorption
E.IM injection route
48.What binds the chemicals together, produced by many companies, and not just the
company that came up with it
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A.Administering drugs
B.The internet
C.Generic drugs

D.Abdorption
E.IM injection route

49.Depend on fat content and work faster on skinnier people → SUBQ INJECTION
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A. TRUE

B, FALSE

50.A client with myasthenia gravis has become frequently complaining of weakness
and fatigue. The physician plans toidentify whether the client is responding to an
overdose of the medication or a worsening of the disease. A tensilon testis performed.
Which of the following would indicate that the client is experiencing an overdose of the
medication?
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A. Temporarily worsening of the condition.

B. Improvement of the weakness and fatigue.

C. No change in the condition.
D. Complaints of muscle spasms.

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ANSWER A.
Temporarily worsening of the condition. Tensilon test/ injection of edrophonium is performed to
diagnose cholinergic crisis
(overdose with anticholinesterase) or myasthenic crisis (under medication). A tensilon injection
makes the client in
cholinergic crisis temporarily worse (negative tensilon test). An improvement in the weakness
indicates myasthenia crisis
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