Nsg Pharm Practice Test #1

Which instruction will the nurse include when teaching a client about the proper use of metered-dose inhalers?

• "After you inhale the medication once, repeat until you obtain relief."

• "Make sure that you puff out air repeatedly after you inhale the medication."

• "Hold your breath for 10 seconds if you can after you inhale the medication."

• "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler."

What is the most important thing to teach the client with a history of diabetes and asthma who has started on albuterol PRN?

• Take tylenol for headaches when taking albuterol.

• Monitor for orthostatic hypotension every 2 hours when taking albuterol.

• Monitor blood glucose levels every 4 hours when taking albuterol.

• An antianxiety agent may be prescribed to help with nervousness.

The healthcare provider orders ipratropium bromide (Atrovent), albuterol (Proventil), and beclomethasone (Vanceril) inhalers for a client. What is the nurses best action?

• Question the order; three inhalers should not be given at one time.

• Administer the albuterol first, wait five minutes and administer ipratropium bromide, followed by beclomethasone several minutes later.

• Administer each inhaler at thirty minute intervals.

• Administer beclomethasone first, wait two minutes, and administer ipratropium bromide, followed by the albuterol several minutes later.

A patient who is taking a xanthine derivative for chronic bronchitis asks the nurse " i miss my morning coffee, I can't wait to go home and have some" what is the nurses best response.

•  I know how you feel, i miss my coffee too.

• I can get some coffee for you, ill be right back.

• Its important not to take coffee or other caffeinated products with this medication as it may cause an increased HR as well as other problems.

• You've been on this medication for a few days, i can call your prescriber to ask whether you can have some coffee.

During a medication review session, a client comments, "I just do not know why I am taking all of these pills." This comment suggests which nursing diagnosis?

• Risk for injury

• Knowledge deficit

• Risk for aspiration

• Anxiety

A pediatric client is ordered to receive 3 mg/kg of a medication. The client weighs 88 pounds. The medication is available in a 15 mg/mL elixir. How much medication should the client receive?

• 2 ml

• 4 ml

• 8 ml

• 16 ml

What is bioavailability?

• The amount of drug that is biometrically excreted in your blood.

• The amount of available drug to be used for biological testing

• The amount of medication in your blood that is available to produce an effect.

• The amount of blood that is available for transfusion.

What is the role of corticosteroids in the treatment of acute respiratory disorders?

• They decrease inflammation.

• They directly dilate the bronchi.

• They stimulate the immune system.

• They increase gas exchange in the alveoli.

The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first?

• Albuterol (Ventolin) 2.5 mg per nebulizer

• Methylprednisolone (Solu-Medrol) 60 mg IV

• Salmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI)

• Triamcinolone (Azmacort) 2 puffs per metered-dose inhaler (MDI)

It is important for the nurse to be aware of the four sequential processes of the pharmacokinetic phase. What are these processes? (In the correct order)

•  Absorption, metabolism, distribution, excretion

•  Biotransformation, excretion, absorption, metabolism

• Absorption, distribution, metabolism, excretion

• Metabolism, distribution, absorption, excretion

Native American client is newly diagnosed with diabetes mellitus type 2 and is prescribed the antidiabetic drug metformin (Glucophage) 500 mg PO with morning and evening meals. Which statement best indicates to the nurse that the client will adhere to the pharmacotherapy?

• "I will no longer put sugar on my cereal."

• "I will feel better soon if I take this medicine."

•  "I need to take the medicine as scheduled to reduce the possibility of damage to my body."

•  "I have diabetes because of my ancestry."

Most common complication insulin therapy:

• Hypotension

• Gallstones

• Lipodystrophies

• Hypoglycemia

• Retinopathy

Discharge teaching for a client receiving a beta-agonist bronchodilator should emphasize reporting which side effect?

• Hypoglycemia

• Nonproductive cough

• Tachycardia

• Sedation 

A client demonstrates understanding of flunisolide (AeroBid) by saying that he will do what?

• Take two puffs to treat an acute asthma attack.

• Rinse his mouth with water after each use.

• Immediately stop taking his oral prednisone when he starts using AeroBid.

• Not use his albuterol inhaler while he is taking AeroBid

A client with COPD has an acute bronchospasam. The nurse knows that which is the best medication for this emergency situation?

• Zafirlukast (Accolate)

• Epinephrine (Adrenalin)

• Dexamethasone (Decadron)

• Oxtriphylline-theophyllinate (Choledyl)

Which of the following insulins has no peak but a duration of 24 hours?

• Novolog

• Lantus

• NPH

• Humalin N

Dramatic decrease in systemic availability of a drug following oral administration is most likely due to:

•  extreme drug instability at stomach pH

•  hepatic "first-pass" effect

•  drug metabolized by gut flora

• Tablet does not dissolve

The nurse notices that one of the client's drugs has a low therapeutic index. What is the most important nursing implication of this?

• A wide margin of safety

• A narrow margin of safety

• Measured 1 hour after administration

• Measured 10 minutes after administration

The nurse performs discharge teaching with a client who is prescribed the anticholinergic inhaler ipratropium bromide (Atrovent). Which statement by the client indicates to the nurse that teaching has been successful?

• "I will not drink grapefruit juice while taking this drug."

•  "I may gain weight as a result of taking this medication."

•  "This inhaler is not to be used alone to treat an acute asthma attack."

•  "Nausea and vomiting are common adverse effects of this medication."

You administered 5 units of Humalog at 0800. What is the ONSET and DURATION of this medication?

•  Onset: 15 minutes, Duration: 3 hours

•  Onset: 2 hours, Duration: 16 hours

• Onset: 30 minutes, Duration: 1 hour

• Onset: 2 hours, Duration: 24 hours

A patient is scheduled to take a morning dose of Metformin. The patient is scheduled for surgery tomorrow. Which of the following nursing interventions are correct?

• Administer the medication as ordered. 

• Hold the dose and notify the doctor for further orders.

• Administer the medication as ordered but hold the next day's dose.

• Check the patient’s blood glucose prior to administering the medication.

A client with a history of asthma is short of breath and says, I feel like i'm having an asthmatic attack." What is the nurse's best action?

• Call a code

• Ask the client to describe the symptoms.

• Administer a beta2 adrenic agonist.

• Administer a long-acting glucocorticoid.

After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky" with slight tremors of the hands. The patients HR is 98 BPM, increased from the pretreatment rate of 88 BPM the nurse knows this reaction is...

• Allergic reaction to the albuterol.

• Expected adverse effect.

• Indication that he has received an overdose of the medication.

• Idiosyncratic creation of the medications.

The nurse understands the differences between drug excretion in children and that in adults. With this knowledge, the nurse makes the which decision in administering medication to children?

•  Because most children need a higher dose of medications, the nurse will contact the physician for an increase in the ordered dose.

• Because children excrete drugs rapidly, the nurse will need to assess carefully for therapeutic effects of the medication.

• The most important assessment is to evaluate for drug accumulation, because the excretion of drugs in children is slower.

• The excretion of most drugs is the same in children as in adults, but assessments are important to avoid side effects.

A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, diaphoresis, and pallor. Which of the following actions by the healthcare provider is the priority?

• Send blood to the laboratory for analysis

• Administer 50% dextrose IV per protocol

• Administer oxygen per nasal cannula

• Administer the prescribed insulin.

 A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NpH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse tells the client to:

• Freeze the insulin.

• Refrigerate the insulin.

• Store the insulin in a dark, dry place.

• Keep the insulin at room temperature.

Which of the following insulins can be administered intravenously?

• NPH

• Humulin R

• Lantus

• Novolog

When administering magnesium sulfate the nurse knows to take these assessments into special consideration (select all that apply)

• Temperature

• Respirations

• Urinary Output

• Blood pressure 

• Pulse

Drug delivery method LEAST suitable for long term (days to weeks) slow release.

• Pellet implant under the skin (subcutaneous)

• Time release capsule

•  i.m. injection of a drug-oil suspension

•  transdermal patch

The nurse completes an admission assessment on a patient with asthma. Which information given by patient is most indicative of a need for a change in therapy?

• The patient uses albuterol (Proventil) before any aerobic exercise.

•  The patient says that the asthma symptoms are worse every spring.

• The patient's heart rate increases after using the albuterol (Proventil) inhaler.

• The patient's only medications are albuterol (Proventil) and salmeterol (Serevent).

The client is receiving potassium supplements. What is the most important nursing implication when administering this drug?

•  It cannot be given as an IV bolus.

•  It must be diluted.

• It must be chilled before administration.

•  It must be given only at bedtime.

The client gained 10 pounds in 2 days. It is determined that the weight gain is caused by fluid retention. The nurse correctly estimates that the weight gain may be equivalent to how many liters of fluid?

• 2

• 3

• 4

• 5

The nurse reviews the client's list of medications with the client. The nurse knows that the 88-years-old client's slower absorption of oral medications is primarily because of which phenomenon?

• Decreased cardiac output

•  Decreased blood flow

• Decreased enzyme function

•  Increased pH of gastric secretions

Pharmacokinetics is BEST defined by which of the following?

• How the drug affects the body.

• The amount of drug necessary to produce a desired effect.

• The use of drugs for treatment.

• The process of a drug entering circulation.

• How the body moves and affects a drug.

Factors which may reduce drug bioavailability:

• Exposure to digestive enzymes

• Gastric acid instability

• Absence of intestinal flora (bacteria)

• First pass effect

Effective in the immediate management of the comatose, hypoglycemic patient.

• Have the patient drink orange juice

• Provide IV infusion of 50% glucose solution

• Glucagon injection -- subcutaneous or intramuscular

• Both b & C

Factor(s) which may change intrinsic drug clearance:

• Dietary considerations

• Smoking

• Age

• B12

• Genetic factors

Factor(s) influencing the volume of distribution: (Select all that apply)

• Patient's gender

• Route of administration

• Patient's age

• Patient's disease state

• Patient's body composition

Effects associated with insulin- induced hypoglycemia: Select all that apply

• Tachycardia

• Palpitations 

• Headaches

• Diaphoresis

• Polyuria

• Nausea

A child is ordered to receive naloxone (Narcan) IV, STAT. The child's weight is 20 kg, and the recommended child's drug dosage is 0.01 mg/kg. Naloxone is available in 400 mcg/mL solution. The nurse should administer: 

Nursing responsibilities in the assessment phase of the nursing process include which responsibilities? (Select all that apply.)

•  Identify side effects of drugs that are nonspecific

• Check peak and trough levels of drugs

• Advise client to avoid fatty foods prior to ingesting an enteric coated tablet

• Evaluate client's reaction to drug