Pharmacology Examination

100 Questions  I  By Nursejbv21
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 Pharmacology Examination
Pharmacology has evolved over the years. Originally a scientific discipline that described the overt effects of biologically active chemicals, pharmacology now explores the molecular mechanisms by which drugs cause biological effects. In the broadest sense, pharmacology is the study of how chemical agents, both natural and synthetic (i. E. , drugs) affect biological systems. This encompasses investigation of the derivation, chemical properties, physiological and behavioral effects, mechanisms of action, biological transformations, and the therapeutic and non-therapeutic uses of drugs. Pharmacological studies can determine the effects of chemical agents upon subcellular, systemic, physiological or behavioral processes; focus on the treatment and prevention of diseases; or deal with more

  
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  • 1. 
    Which of the following is not a side effect of the cholinoreceptor blocker (Atropine)?
    • A. 

      Increased pulse

    • B. 

      Urinary retention

    • C. 

      Constipation

    • D. 

      Mydriasis


  • 2. 
    Which of the following is not a side effect of the Ace Inhibitor (Captopril)?
    • A. 

      Rash

    • B. 

      Angioedema

    • C. 

      Cough

    • D. 

      Congestion


  • 3. 
    Which of the following is not a side effect of the Vasodilator (Nifedipine)?
    • A. 

      Nausea

    • B. 

      Flush appearance

    • C. 

      Vertigo

    • D. 

      Sexual dysfunction


  • 4. 
    Which of the following is not a side effect of the Dieuretics (Loop dieuretics)?
    • A. 

      Alkalosis

    • B. 

      Nausea

    • C. 

      Hypotension

    • D. 

      Potassium deficits


  • 5. 
    Which of the following are not treated with Hydrochlorothiazide?
    • A. 

      CHF

    • B. 

      HTN

    • C. 

      Nephritis

    • D. 

      Hypercalciuria


  • 6. 
    Antianginal agent which decreases myocardial contractility (negative inotropism):
    • A. 

      Nitroglycerin

    • B. 

      Amyl nitrate

    • C. 

      Metoprolol (lopressor)

    • D. 

      Amrinone (Inocor)


  • 7. 
     Walter, teenage patient is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?
    • A. 

      Lungs

    • B. 

      Liver

    • C. 

      Kidney

    • D. 

      Adrenal glands


  • 8. 
     A 13-month-old child recently arrived in the United States from a foreign country with his parents and needs childhood immunizations. His mother reports that he is allergic to eggs. Upon further questioning, you determine that the allergy to eggs is anaphylaxis. Which of the following vaccines should he not receive?
    • A. 

      Hepatitis B

    • B. 

      Inactivated polio

    • C. 

      Diphtheria, acellular pertussis, tetanus (DTaP)

    • D. 

      Mumps, measles, rubella (MMR)


  • 9. 
     Mandy, a patient calls the clinic today because he is taking atrovastatin (Lipitor) to treat his high cholesterol and is having pain in both of his legs. You instruct him to:
    • A. 

      Stop taking the drug and make an appointment to be seen next week.

    • B. 

      Continue taking the drug and make an appointment to be seen next week.

    • C. 

      Stop taking the drug and come to the clinic to be seen today.

    • D. 

      Walk for at least 30 minutes and call if symptoms continue.


  • 10. 
    The nurse is aware that the following solutions is routinely used to flush an IV device before and after the administration of blood to a patient is:
    • A. 

      0.9 % sodium chloride

    • B. 

      5% Dextrose in water

    • C. 

      Sterile water

    • D. 

      Heparin sodium


  • 11. 
    The nursery nurse is putting erythromycin ointment in the newborn’s eyes to prevent infection. She places it in the following area of the eye: 
    • A. 

      Under the eyelid

    • B. 

      On the cornea

    • C. 

      In the lower conjunctival sac

    • D. 

      By the optic disc


  • 12. 
    The physician orders penicillin for a patient with streptococcal pharyngitis. The nurse administers the drug as ordered, and the patient has an allergic reaction. The nurse checks the medication order sheet and finds that the patient is allergic to penicillin. Legal responsibility for the error is: 
    • A. 

      Only the nurse’s—she should have checked the allergies before administering the medication.

    • B. 

      Only the physician’s—she gave the order, the nurse is obligated to follow it.

    • C. 

      Only the pharmacist’s—he should alert the floor to possible allergic reactions.

    • D. 

      The pharmacist, physician, and nurse are all liable for the mistake


  • 13. 
     James Perez, a nurse on a geriatric floor, is administering a dose of digoxin to one of his patients. The woman asks why she takes a different pill than her niece, who also has heart trouble. James replies that as people get older, liver and kidney function decline, and if the dose is as high as her niece’s, the drug will tend to: 
    • A. 

      Have a shorter half life

    • B. 

      Accumulate

    • C. 

      Have decreased distribution

    • D. 

      Have increased absorption


  • 14. 
    The nurse is administering Augmentin to her patient with a sinus infection. Which is the best way for her to insure that she is giving it to the right patient? 
    • A. 

      Call the patient by name

    • B. 

      Read the name of the patient on the patient’s door

    • C. 

      Check the patient’s wristband

    • D. 

      Check the patient’s room number on the unit census list


  • 15. 
    The most important instructions a nurse can give a patient regarding the use of the antibiotic Ampicillin prescribed for her are to 
    • A. 

      Call the physician if she has any breathing difficulties.

    • B. 

      Take it with meals so it doesn’t cause an upset stomach.

    • C. 

      Take all of the medication prescribed even if the symptoms stop sooner.

    • D. 

      Not share the pills with anyone else.


  • 16. 
    When counseling a patient who is starting to take MAO (monoamine oxidase) inhibitors such as Nardil for depression, it is essential that they be warned not to eat foods containing tyramine, such as: 
    • A. 

      Roquefort, cheddar, or Camembert cheese.

    • B. 

      Grape juice, orange juice, or raisins.

    • C. 

      Onions, garlic, or scallions.

    • D. 

      Ground beef, turkey, or pork.


  • 17. 
    Mrs. Jane Gately has been dealing with uterine cancer for several months. Pain management is the primary focus of her current admission to your oncology unit. Her vital signs on admission are BP 110/64, pulse 78, respirations 18, and temperature 99.2 F. Morphine sulfate 6mg IV, q 4 hours, prn has been ordered. During your assessment after lunch, your findings are: BP 92/60, pulse 66, respirations 10, and temperature 98.8. Mrs. Gately is crying and tells you she is still experiencing severe pain. Your action should be to 
    • A. 

      give her the next ordered dose of MS.

    • B. 

      give her a back rub, put on some light music, and dim the lights in the room.

    • C. 

      report your findings to the RN, requesting an alternate medication order

    • D. 

      be obtained from the physician.

    • E. 

      Call her daughter to come and sit with her.


  • 18. 
    The physician orders an intramuscular injection of Demerol for the postoperativepatient’s pain. When preparing to draw up the medication, the nurse is careful to remove the correct vial from the narcotics cabinet. It is labeled 
    • A. 

      Simethicone

    • B. 

      Albuterol

    • C. 

      Meperedine

    • D. 

      Ibuprofen


  • 19. 
    The nurse is administering an antibiotic to her pediatric patient. She checks the patient’s armband and verifies the correct medication by checking the physician’s order, medication kardex, and vial. Which of the following is not considered one of the five “rights” of drug administration? 
    • A. 

      Right dose

    • B. 

      Right route

    • C. 

      Right frequency

    • D. 

      Right time


  • 20. 
     A nurse is preparing the client’s morning NPH insulin dose and notices a clumpy precipitate inside the insulin vial. The nurse should: 
    • A. 

      Draw up and administer the dose

    • B. 

      Shake the vial in an attempt to disperse the clumps

    • C. 

      Draw the dose from a new vial

    • D. 

      Warm the bottle under running water to dissolve the clump


  • 21. 
    Britney is admitted with a diagnosis of schizophrenia. The client refuses to take medication and states “I don’t think I need those medications. They make me too sleepy and drowsy. I insist that you explain their use and side effects.” The nurse should understand that: 
    • A. 

      a referral is needed to the psychiatrist who is to provide the client with answers

    • B. 

      the client has a right to know about the prescribed medications

    • C. 

      such education is an independent decision of the individual nurse whether or not to teach clients about their medications

    • D. 

      clients with schizophrenia are at a higher risk of psychosocial complications when they know about their medication side effects


  • 22. 
    Carol has a nasogastric tube after colon surgery. Which one of these tasks can be safely delegated to an unlicensed assistive personnel (UAP)? 
    • A. 

      To observe the type and amount of nasogastric tube drainage

    • B. 

      Monitor the client for nausea or other complications

    • C. 

      Irrigate the nasogastric tube with the ordered irrigant

    • D. 

      Perform nostril and mouth care


  • 23. 
    Angelina, an R.N., reports to work looking unkempt. Maegan, another R.N., approaches when she notices her using uncoordinated movements. Angelina’s breath reeks of peppermints and Maegan suspects Angelina may be intoxicated. What is the best initial nursing action for Maegan to take? 
    • A. 

      Call the supervisor and report Angelina.

    • B. 

      Confront Angelina, saying that she feels she is intoxicated, and relieve her of her nursing duties immediately.

    • C. 

      Ignore the situation.

    • D. 

      Give Angelina a lecture about substance abuse and do nothing else.


  • 24. 
    James with a diagnosis of bipolar disorder has been referred to a local boarding home for consideration for placement. The social worker telephoned the hospital unit for information about the client’s mental status and adjustment. The appropriate response of the nurse should be which of these statements? 
    • A. 

      "I am sorry. Referral information can only be provided by the client’s providers"

    • B. 

      "I can never give any information out by telephone. How do I know who you are?"

    • C. 

      "Since this is a referral, I can give you this information"

    • D. 

      "I need to get the client’s written consent before I release any information to you"


  • 25. 
    A client tells the nurse, "I have something very important to tell you if you promise not to tell." The best response by the nurse is: 
    • A. 

      "I must document and report any important information."

    • B. 

      "I can’t make such a promise."

    • C. 

      "That depends on what you tell me."

    • D. 

      "I must report everything to the treatment team."


  • 26. 
     Helen, a nurse from the maternity unit is floated to the critical care unit because of staff shortage on the evening shift. Which client would be appropriate to assign to this nurse? A client with: 
    • A. 

      Dopamine drip IV with vital signs monitored every 5 minutes

    • B. 

      a myocardial infarction that is free from pain and dysrhythmias

    • C. 

      a tracheotomy of 24 hours in some respiratory distress

    • D. 

      a pacemaker inserted this morning with intermittent capture


  • 27. 
    A client with Guillain-Barré syndrome has been on a ventilator for three weeks, and can communicate only with eye blinks because of quadriplegia. The intensive care nursing staff sometimes have no time for this tedious communication process. The client’s family comes infrequently since they run a family-owned restaurant that does not close until visiting hours are over. How should the nurse respond to the family’s request for exemption from visiting hours? 
    • A. 

      Arrange for a volunteer to stay with the client during the day to provide for socialization needs and to facilitate communication with staff.

    • B. 

      Explain to the family that consistency in enforcing rules is important to prevent complaints from the families of other clients.

    • C. 

      Suggest that the family visit in shifts during the normal visiting hours, since the client needs to sleep at night.

    • D. 

      Make an exception to visiting regulations because of the long-term nature of the client’s recovery and the need for family support.


  • 28. 
     Zantac is ordered for an adult client. The nurse mistakenly administered Xanax. What is the most appropriate action for the nurse to take? 
    • A. 

      Notify the physician and document in the nurse’s notes that the physician was notified of the error.

    • B. 

      Notify the supervisor, complete a medication error incident report, and document in the nurse’s notes that an incident report was completed

    • C. 

      Notify the house supervisor, assess client carefully, and document only if adverse or untoward effects occur.

    • D. 

      Notify the physician, complete an incident report, and document the notification of the physician and any assessments made.


  • 29. 
    When assessing a client, it is important for the nurse to be informed about cultural issues related to the client’s background because: 
    • A. 

      Normal patterns of behavior may be labeled as deviant, immoral, or insane

    • B. 

      The meaning of the client’s behavior can be derived from conventional wisdom

    • C. 

      Personal values will guide the interaction between persons from 2 cultures

    • D. 

      The nurse should rely on her knowledge of different developmental mental stages


  • 30. 
     Robin, an adult male is scheduled for exploratory surgery this morning. After he is premedicated for surgery the nurse reviews his chart and discovers that he has not signed a consent form. The nurse’s action is based on which of the following understandings? 
    • A. 

      Since the client came to the hospital consent is implied even if the consent for the surgery has not been signed.

    • B. 

      All invasive procedures require a consent form.

    • C. 

      The nurse should have him sign a consent form immediately

    • D. 

      The nurse should have the next of kin sign the necessary consent form


  • 31. 
     An adult client has continued slow bleeding from the graft after repair of an abdominal aortic aneurysm. Because of the client’s unstable condition, he is in the intensive care unit where visitors are limited to the family. The client insists on having a visit from a medicine man whom the family visits regularly. How should the nurse interpret this request? 
    • A. 

      The principle of justice prohibits giving one client a privilege that other clients are not permitted.

    • B. 

      Faith healers do not meet the standards for clergy exemption from visitation rules.

    • C. 

      Medicine men are not approved by the hospital as legitimate health care providers.

    • D. 

      Provision of holistic care requires that the client’s belief system is honored.


  • 32. 
     Mrs. Jefferson is an 88-year-old client at a long-term care facility. Prior to administering any medication or treatment to this client the nurse must confirm identity by: 
    • A. 

      Asking the client if she is Mrs. Jefferson.

    • B. 

      Reading the client’s identification bracelet

    • C. 

      Reading the client’s medical record.

    • D. 

      Asking the roommate to state the client’s name.


  • 33. 
    A client receiving hydrochlorothiazide is instructed to increase her dietary intake of potassium. The best snack for the client requiring increased potassium is: 
    • A. 

      Pear

    • B. 

      Apple

    • C. 

      Orange

    • D. 

      Banana


  • 34. 
     A client hospitalized with severe depression and suicidal ideation refuses to talk with the nurse. The nurse recognizes that the suicidal client has difficulty: 
    • A. 

      Expressing feelings of low self-worth

    • B. 

      Discussing remorse and guilt for actions

    • C. 

      Displaying dependence on others

    • D. 

      Expressing anger toward others


  • 35. 
    A client is advised to take senna (Senokot) for the treatment of constipation asks the nurse how this medication works. The nurse responds knowing that it: 
    • A. 

      Accumulates water in the stool and increases peristalsis

    • B. 

      Stimulates the vagus nerve

    • C. 

      coats the bowel wall

    • D. 

      Adds fiber and bulk to the stool


  • 36. 
    A client is receiving heparin sodium by continuous intravenous infusion. The nurse monitors the client for which adverse effect of this therapy? 
    • A. 

      Decreased blood pressure

    • B. 

      Increased pulse rate

    • C. 

      Ecchymoses

    • D. 

      Tinnitus


  • 37. 
    A client is being treated for acute congestive heart failure (CHF) and the client’s vital signs are as follows: BP 85/50 mm Hg; pulse, 96 bpm; respirations, 26 cpm. The physician prescribes digoxin (Lanoxin). To evaluate a therapeutic effectiveness of this medication, the nurse would expect which of the following changes in the client’s vital signs?
    • A. 

      BP 85/50 mm Hg, pulse 60 bpm, respirations 26 cpm

    • B. 

      BP 98/60 mm Hg, pulse 80 bpm, respirations 24 cpm

    • C. 

      BP 130/70 mm Hg, pulse 104 bpm, respirations 20 cpm

    • D. 

      BP 110/40 mm Hg, 110 bpm, respirations 20 cpm


  • 38. 
    Diazepam (Valium) is prescribed for a client with anxiety. The nurse instructs the client to expect which side effect? 
    • A. 

      Incoordination

    • B. 

      Cough

    • C. 

      Tinnitus

    • D. 

      Hypertension


  • 39. 
    A client receives oxytocin (Pitocin) to induce labor. During the administration of the oxytocin, it is most important for the nurse to monitor: 
    • A. 

      Urinary output

    • B. 

      Fetal heart rate

    • C. 

      Central venous pressure

    • D. 

      Maternal blood glucose


  • 40. 
    A client who is taking rifampin (Rifadin) as part of the medication regimen for the treatment of tuberculosis calls the clinic nurse and reports that her urine is a red-orange color. The nurse tells the client to: 
    • A. 

      Come to the clinic to provide a urine sample

    • B. 

      Stop the medication until further instructions are given by the physician

    • C. 

      Take the medication dose with an antacid to prevent this adverse effect

    • D. 

      Expect a red-orange color in urine, feces, sweat, sputum, and tears as a harmless side effect


  • 41. 
    A clinic nurse is performing assessment on a client who is being seen in the clinic for the first time. When asking about the client’s medication history, the client tells the nurse that he takes nateglinide (Starlix). The nurse then questions the client about the presence of which disorder that is treated with this medication? 
    • A. 

      Hypothyroidism

    • B. 

      Insomnia

    • C. 

      Type 2 diabetes mellitus

    • D. 

      Renal failure


  • 42. 
    A nurse reinforces dietary instruction for the client receiving spironolactone (Aldactone). Which food would the nurse instruct the client to avoid while taking this medication? 
    • A. 

      Crackers

    • B. 

      Shrimp

    • C. 

      Apricots

    • D. 

      Popcorn


  • 43. 
    A home care nurse provides instructions to a client taking digoxin (Lanoxin) 0.25 mg daily. Which statement by the client indcates a need for further instructions? 
    • A. 

      “I will take my prescribed antacid if I become nauseated”

    • B. 

      “It is important to have my blood drawn when prescribed”

    • C. 

      “I will check my pulse before I take my medication”

    • D. 

      “I will carry a medication identification card with me”


  • 44. 
    A client with anxiety disorder is taking buspirone (BuSpar) and tells the nurse that it is difficult to swallow the tablets. The nurse tells the client to: 
    • A. 

      Dissolve the tablet in a cup of coffee

    • B. 

      Crush the tablet before taking it

    • C. 

      Call the physician for a change in medication

    • D. 

      Mix the tablet uncrushed in custard


  • 45. 
    A nurse is caring for a child with CHF provides instructions to the parents regarding the administration of digoxin (Lanoxin). Which statement by the mother indicates a need for further instructions? 
    • A. 

      “If my child vomits after I give the medication, I will not repeat the dose”

    • B. 

      “I will check my child’s pulse before giving the medication”

    • C. 

      “I will check the dose of the medication with my husband before I give the medication”

    • D. 

      “I will mix the medication with food”


  • 46. 
    A client with Parkinson’s disease has begun therapy with levodopa (L- dopa). The nurse determines that the client understands the action of the medication if the client verbalizes that results may not be apparent for: 
    • A. 

      24 hours

    • B. 

      Two to three days

    • C. 

      One week

    • D. 

      Two to three weeks


  • 47. 
    A nurse is caring for a client with a genitourinary tract infection receiving amoxicillin (Augmentin) 500 mg every 8 hours. Which of the following would indicate to the nurse that the client is experiencing an adverse effect related to the medication? 
    • A. 

      Hypertension

    • B. 

      Nausea

    • C. 

      Headache

    • D. 

      Watery diarrhea


  • 48. 
    A nurse in a physician’s office is reviewing the results of a client’s phenytoin (Dilantin) level drawn that morning. The nurse determines that the client has a therapeutic drug level if the client’s result was: 
    • A. 

      3 mcg/ml

    • B. 

      8 mcg/ml

    • C. 

      15 mcg/ml

    • D. 

      24mcg/ml


  • 49. 
    A nurse has formulated a nursing diagnosis of Disturbed Body Image for a client who is taking spironolactone (Aldactone). The nurse based this diagnosis on assessment of which side effect of the medication? 
    • A. 

      Edema

    • B. 

      Weight gain

    • C. 

      Excitability

    • D. 

      Decreased libido


  • 50. 
    A nurse is caring for the client with a history of mild heart failure who is receiving diltiazem hydrochloride (Cardizem) for hypertension. The nurse would assess the client for: 
    • A. 

      Bradycardia

    • B. 

      Wheezing

    • C. 

      Peripheral edema and weight gain

    • D. 

      Apical pulse rate lower than baseline


  • 51. 
    A client has been taking fosinopril (Monopril) for 2 months. The nurse determines that the client is having the intended effects of therapy if the nurse notes which of the following? 
    • A. 

      Lowered BP

    • B. 

      Lowered pulse rate

    • C. 

      Increased WBC

    • D. 

      Increased monocyte count


  • 52. 
    A client is taking labetalol (Normodyne). The nurse monitors the client for which frequent side effect of the medication? 
    • A. 

      Tachycardia

    • B. 

      Impotence

    • C. 

      Increased energy level

    • D. 

      Night blindness


  • 53. 
    A client has an order to begin short-term therapy with enoxaparin (Lovenox). The nurse explains to the client that this medication is being ordered to: 
    • A. 

      Dissolve urinary calculi

    • B. 

      Reduce the risk of deep vein thrombosis

    • C. 

      Relieve migraine headaches

    • D. 

      Stop progression of multiple sclerosis


  • 54. 
    A nurse is providing instructions to a client regarding quinapril hydrochloride (Accupril). The nurse tells the client: 
    • A. 

      To take the medication with food only

    • B. 

      To rise slowly from a lying to a sitting position

    • C. 

      To discontinue the medication if nausea occurs

    • D. 

      That a therapeutic effect will be noted immediately


  • 55. 
    The nurse is teaching the client diagnosed with angina about sublingual nitroglycerin (NTG), a coronary vasodilator. Which statement indicates the client needs more medication teaching?
    • A. 

      "I will always carry my nitroglycerin in a dark colored bottle"

    • B. 

      "If i have chest pain, I will put a tablet underneath my tongue"

    • C. 

      "If my pain is not relieved with one tablet, I will get medical help"

    • D. 

      "I should expect to get a headache after taking my nitroglycerin"


  • 56. 
    The nurse is preparing to administer nitroglycerin, a coronary vasodilator transdermal patch, to the client diagnosed with myocardial infarction. Which intervention should the nurse implement?
    • A. 

      Question applying the patch if the client's BP is less than 110/70

    • B. 

      Use non sterile gloves when applying the transdermal patch

    • C. 

      Date and time transdermal patch prior to applying to client's skin

    • D. 

      Place the transdermal patch on the site where the old patch was removed


  • 57. 

    The nurse is administering0.5 inch of nitro paste, a coronary vasodilator. How much paste should the nurse apply to the application paper?
    • A. 

      1/2"

    • B. 

      1"

    • C. 

      1 1/2"

    • D. 

      2"


  • 58. 
    The client is diagnosed with angina is prescribed nitroglycerin and tells the nurse, "I don't undertand why I can't take my Viagra. I need to take it so that I can make love to my wife." Which statement is the nurse's best response?
    • A. 

      "If you take the medication together, you may get very low blood pressure"

    • B. 

      "You are worried your wife will be concerned if you cannot make love"

    • C. 

      "If you wait at least 8 hours after taking your NTG, you can take your Viagra"

    • D. 

      "You should get clarification with your HCP about taking VIagra"


  • 59. 
    Client’s Name: ABCD Client’s Number: 1234567 Allergies: NKDA Diagnosis: Angina Medication 0701-1500 1501-2300 2301-0700 Regular insulin subcutaneously ac and hs 0-60: 1 amp D50   61-150: 0 units   151-300: 5 units   301-450: 10 units   >450: Call HCP 0730     1130 1630     2100   Metformin (Glucophage) 500 mg PO b.i.d 0800 1700   Atorvastatin (Lipitor) 20 mg PO every day 0900     Nitroglycerin (Nitro-Dur) 0.4 mg/hr on in A.M. 0900     Nitroglycerin (Nitro-Dur) 0.4 mg/hr off in P.M.   2100     The nurse is assessing the preprinted Medication Administration Record (MAR) for a client admitted with angina. Which of medicationorder would the nurse discuss with the pharmacist?
    • A. 

      The 1130 regular insulin order

    • B. 

      The 0800 Glucophage order

    • C. 

      The 0900 Lipitor order

    • D. 

      The 2100 nitroglycerin order


  • 60. 
    The elderly client diagnosed with coronary artery disease has been taking aspirin daily for more than a year. Whish data would warrant notifying the health  care provider?
    • A. 

      The client has lost 5 pounds in the last month

    • B. 

      The client has trouble hearing low tones

    • C. 

      The client reports having a funny taste in the mouth

    • D. 

      The client has hard, dark, tarry stools


  • 61. 
    The nurse is administering 0900 medications to the following clients. To which client would the nurse question administering the medication?
    • A. 

      The client receiving a CCB who drank a glass of grapefruit juice

    • B. 

      The client receiving beta blocker who has an apical pulse of 62 beats per minute

    • C. 

      The client receiving NTG patch who has a blood pressure of 148/92

    • D. 

      The client receiving an anti platelet medication who has a platelet count of 150,000


  • 62. 
    The client diagnosed with a myocardial infarction is receving thrombolytic therapy. Which data would warrant immediate intervention by the nurse?
    • A. 

      The client's telemetry has perfusion dysrhythmias

    • B. 

      The client is oozing blood from the IV site

    • C. 

      The client is alert and oriented to date, time, and name

    • D. 

      The client has no signs of infiltration at the insertion site


  • 63. 
    Which data would indicate to the nurse that simvastatin (Zocor), an HMG-CoA reductase inhibitor is effective?
    • A. 

      The client's BP is 132/80

    • B. 

      The client's cholesterol level is 180 mg/dL

    • C. 

      The client's LDL is 180 mg/dL

    • D. 

      The client's HDL is 35 mg/dL


  • 64. 
    The client is receiving an IV infusion of heparin. The bag hanging has 20,000 units of heparin in 500 mL of D5W at 22 mL per hour via an IV pump. How many units of heparin is the client receving every hour?

  • 65. 
    The client taking digoxin,  a cardiac glycoside, has  a serum digoxin level of 4.2 ng/mL. WHich medication should the nurse anticipate the HCP prescribing?
    • A. 

      The digitalis binder Fab antibody fragments (Digibind)

    • B. 

      The loop diuretic furosemide (Lasix)

    • C. 

      None

    • D. 

      The cardiac glycoside digoxin (Lanoxin)


  • 66. 
    The nurse is preparing to administer medications to the following clients. Which of the following client would the nurse question administering the medication?
    • A. 

      The client receiving the angiotensin-receptor blocker losartan (Cozaar) who has a BP of 168/94

    • B. 

      The client receiving the calcium channel blocker diltiazem (Cardizem) who has 1+ non pitting edema

    • C. 

      The client receiving the alpha blocker terazosin (Hytrin) who is complaining of Headache

    • D. 

      The client receiving the thiazide diuretic hydrochlorothiazide (HCTZ) who is complaining of leg cramps


  • 67. 
    The nurse is preparing to administer spironolactone (Aldactone), a potassium sparing diuretic. Which priority intervention should the nurse implement?
    • A. 

      Check the client's potassium level

    • B. 

      Monitor the client's urinary output

    • C. 

      Encourage consumption of potassium rich foods

    • D. 

      Give medication with food


  • 68. 
    The emergency department nurse received a client with multiple hematomas and has an International Normalized Ratio of 7.2. Which medication should the nurse prepare to administer?
    • A. 

      Protamine sulfate

    • B. 

      Heparin

    • C. 

      AquaMEPHYTON

    • D. 

      Vitamin C


  • 69. 
    The client on telemetry is showing multifocal premature ventricular contractions. Which antidysrhythmic medication should the nurse administer?
    • A. 

      Lidocaine

    • B. 

      Atropine

    • C. 

      Adenosine

    • D. 

      Epinephrine


  • 70. 
    Which client would the nurse most likely suspect will require polypharmacy to control essential hypertension?
    • A. 

      The 84-year-old white male client

    • B. 

      The 22-year-old Hispanic female client

    • C. 

      The 60-year-old Asian female client

    • D. 

      The 46-year-old African American male client


  • 71. 
    The nurse is preparing to hang the next bag of heparin to a client diagnosed with deep vein thrombosis (DVT) . The client's current laboratory values are as follows: PT: 12.7 Control: 12.9 INR: 1 PTT: 62 Control: 36 Which intervention should the nurse implement?
    • A. 

      Hang the intravenous bag at the same rate

    • B. 

      Order a STAT PT/INR/PTT

    • C. 

      Notify the physician

    • D. 

      Assess the client for abnormal bleeding


  • 72. 
    The nurse is preparing to administer warfarin (Coumadin), an anticoagulant. The client's current laboratory values are as follows: PT: 38 Control: 12.9 INR: 5.9 PTT: 39 Control: 36 Which action should the nurse implement?
    • A. 

      Discontinue the intravenous bag immediately

    • B. 

      Prepare to administer vitamin K

    • C. 

      Notify the health care provider to increase the dose

    • D. 

      Administer the medication as ordered.


  • 73. 
    The client diagnosed with arterial hypertension is receiving furosemide (Lasix), a loop diuretic. WHich data indicates the medication is effective?
    • A. 

      Eight hour intake of 1800 mL and the output is 2300 mL

    • B. 

      BP went from 144/88 to 154/96

    • C. 

      Weight loss of 1.3 kg in 7 days

    • D. 

      Client reports occasional lightheadedness and dizziness


  • 74. 
    The client diagnosed with essential hypertension is taking the loop diuretic bumetanide (Bunex). WHich statement by the client would warrant notifying the client's health care provider?
    • A. 

      "I really wish my mouth would not be so dry"

    • B. 

      "I get a little dizzy when I get up too fast"

    • C. 

      "I usually have one to two glasses of wine a day"

    • D. 

      "I have been experiencing really bad leg cramps"


  • 75. 
    The client diagnosed with DVT asks the nurse, "Why do I have to take Coumadin in the evening?" Which statement would be the nurse's best response?
    • A. 

      "The medication works more effectively while you are sleeping"

    • B. 

      "The medicine should be given with the largest meal of the day"

    • C. 

      The side effect of the Coumadin are less if you take it in the evening"

    • D. 

      This allows for a more accurate INR level when we draw your morning labs"


  • 76. 
    A client is ordered 35 milligrams of Codeine phosphate by subcutaneous injection. 50 milligrams in 1 millilitre of liquid for SC Injection is available. How many millilitres will you administer?  

  • 77. 
    A client is ordered 50 milligrams of Amoxicillin trihydrate orally. 125 milligrams in 5 millilitres of Syrup is available. How many millilitres will you administer?

  • 78. 
    A client is ordered 75 milligrams of Aminophylline intravenously. 250 milligrams in 10 millilitres of liquid for IV Injection is available. How many millilitres will you administer?  

  • 79. 
    Convert 93074 milligrams to grams.

  • 80. 
    A client is ordered 30 milligrams of Codeine phosphate. 60 milligram tablets are available. How many tablets will you give?

  • 81. 
     One litre of Dextrose 5% in water is charted over 3 hours. The drop factor is 10. The IV has been running for 1 hour and 15 minutes. 500 mls remain. How many drops per minute are needed so that the IV finishes in the required time?

  • 82. 
    You are required to administer 1 litre of Normal Saline over 7 hours. The drop factor is 15. How many drops per minute are required to start the flow off at the correct rate?

  • 83. 
    One hundred millilitres of IV Fluids is charted over 2.5 hours. The drop factor is 15. Calculate the number of drops per minute.

  • 84. 
    Three litres of Hartmans (Lactated Ringer's) is charted over 12 hours. The drop factor is 15. The IV has been running for 9 hours. 800 mls remain. How many drops per minute are needed so that the IV finishes in the required time?

  • 85. 
    Calculate the drip rate for 500 mls of Dextrose 5% in water to be given over 4 hours via a giving set which delivers 15 drops/ml.  

  • 86. 
    You are required to administer 3 litres of IV Fluids over 12 hours. The drop factor is 10. How many drops per minute are required to start the flow off at the correct rate?

  • 87. 
    Calculate the drip rate for 500 mls of Normal Saline to be given over 4.5 hours via a giving set which delivers 15 drops/ml.

  • 88. 
    You are required to administer 500 mls of Normal Saline over 3.5 hours. The drop factor is 10. How many drops per minute are required to start the flow off at the correct rate?

  • 89. 
    One and a half litres of Normal Saline is required to be given over 4 hours. Using a giving set which delivers 10 drops/ml how many drops per minute will need to be given?

  • 90. 
    A client is ordered 2.5 milligrams of Promethazine hydrochloride orally. 5 milligrams in 5 millilitres of elixir is available. How many millilitres will you administer?

  • 91. 
    The nurse is administering the combination medication Tenoretic (clorthalidone and atenolol), a thiazide diuretic and a beta blocker, to a client diagnosed with chronic hypertension. Which interventions should the nurse implement? Select all that apply.
    • A. 

      Do not administer if the client's BP is less than 90/60

    • B. 

      Do not administer if the client's apical pulse is less than 60

    • C. 

      Teach the client how to prevent orthostatic hypotension

    • D. 

      Encourage the client to eat potassium-rich foods

    • E. 

      Monitor the client's oral intake and urinary output


  • 92. 
    The health care provider prescribed a beta blocker for the client diagnosed with arterial hypertension. Which is the scientific rationale for administering this medication?
    • A. 

      This medication decreases the sympathetic stimulation to the heart, thereby decreasing the client's heart rate

    • B. 

      This medication prevents the calcium from entering the cell, which helps decrease the client's blood pressure

    • C. 

      This medication prevents the release of aldosterone, which deceases absorption of sodium and water, which in turn, decreases blood pressure

    • D. 

      This medication will cause an increase excretion of water from the vascular system, which will decrease the blood pressure


  • 93. 
    The client is receiving an IV infusion heparin. The bag hanging has 10,000 units of heparin in 100 mL of D5W. The HCP has ordered the medication to be delivered at 1000 units per hour. At what rate would the nurse set the IV pump?

  • 94. 
    The female client diagnosed with congestive heart failure tells the nurse that she has been taking hawthorn extract, an OTC medication, since the HCP told her that she had heart problems. Which statement by the nurse would be appropriate?
    • A. 

      "You need to take garlic supplements with hawthorn for it to be effective"

    • B. 

      "You should stop taking this herb immediately because it can cause more problems"

    • C. 

      "This herb can cause bleeding if you take it with your other medications"

    • D. 

      "Some clients find this is helpful, but make sure your HCP is aware of the medication"


  • 95. 
    The client diagnosed with bacterial endocarditis is prescribed gentamycin intravenous piggyback (IVPB). The IVPB comes in 100 mL of fluid to be administered over 1 hour on an IV pump. At what rate should the nurse administer the medication?

  • 96. 
    Which assessment data should the nurse obtain prior to administering a calcium channel blocker?
    • A. 

      Serum calcium level

    • B. 

      Client's radial pulse

    • C. 

      Client's telemetry reading

    • D. 

      Client's blood pressure


  • 97. 

    Using the last strip of the ECG of the patient. The client is exhibiting the following telemetry strip. Which intervention should the nurse implement? Select all that apply?
    • A. 

      Administer the antidysrhythmic atropine

    • B. 

      Assess the client's apical heart rate

    • C. 

      Administer epinephrine

    • D. 

      Initiate CPR

    • E. 

      Administer lidocaine


  • 98. 
    The HCP prescribed an Angiotensin-converting enzyme (ACE) inhibitor for a client diagnosed with congestive heart failure. Which instruction should the nurse provide?
    • A. 

      Eat banana or drink orange juice at least twice a day

    • B. 

      Notify the HCP if you develop localized edematous areas that itch

    • C. 

      A dry cough is expected early in the morning on arising

    • D. 

      The symptoms of CHF should improve rapidly


  • 99. 
    Mrs. Garvey has been dealing with uterine cancer for several months. Pain management is the primary focus of her current admission to your oncology unit. Her vital signs on admission are BP 110/64, pulse 78, respirations 18, and temperature 99.2 F. Morphine sulfate 6mg IV, q 4 hours, prn has been ordered. During your assessment after lunch, your findings are: BP 92/60, pulse 66, respirations 10, and temperature 98.8. Mrs. Garvey is crying and tells you she is still experiencing severe pain. Your action should be to 
    • A. 

      Give her the next ordered dose of MS.

    • B. 

      Give her a back rub, put on some light music, and dim the lights in the room.

    • C. 

      Report your findings to the RN, requesting an alternate medication order be obtained from the physician.

    • D. 

      Call her daughter to come and sit with her.


  • 100. 
    The physician orders penicillin for a patient with streptococcal pharyngitis. The nurse administers the drug as ordered, and the patient has an allergic reaction. The nurse checks the medication order sheet and finds that the patient is allergic to penicillin. Legal responsibility for the error is 
    • A. 

      Only the nurse’s—she should have checked the allergies before adminis- tering the medication.

    • B. 

      Only the physician’s—she gave the order, the nurse is obligated to follow it.

    • C. 

      Only the pharmacist’s—he should alert the floor to possible allergic reactions.

    • D. 

      The pharmacist, physician, and nurse are all liable for the mistake.


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