NCLEX Pharmacology Quiz 4 (10 Items)

1.

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

Correct Answer
C. Draw the dose from a new vial

Explanation
The nurse should always inspect the vial of insulin before use for solution changes that may signify loss of potency. NPH insulin is normally uniformly cloudy. Clumping. frosting. and precipitates are signs of insulin damage. In this situation. because potency is questionable. it is safer to discard the vial and draw up the dose from a new vial.

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2.

A client with histoplasmosis has an order for ketoconazole (Nizoral). The nurse teaches the client to do which of the following while taking this medication?

A.

Take the medication on an empty stomach
B.

Take the medication with an antacid
C.

Avoid exposure to sunlight
D.

Limit alcohol to 2 ounces per day

Correct Answer
C. Avoid exposure to sunlight

Explanation
The client should be taught that ketoconazole is an antifungal medication. It should be taken with food or milk. Antacids should be avoided for 2 hours after it is taken because gastric acid is needed to activate the medication. The client should avoid concurrent use of alcohol. because the medication is hepatotoxic. The client should also avoid exposure to sunlight. because the medication increases photosensitivity.

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3.

A nurse has taught a client taking a xanthine bronchodilator about beverages to avoid. The nurse determines that the client understands the information if the client chooses which of the following beverages from the dietary menu?

A.

Chocolate milk
B.

Cranberry juice
C.

Coffee
D.

Cola

Correct Answer
B. Cranberry juice

Explanation
Cola. coffee. and chocolate contain xanthine and should be avoided by the client taking a xanthine bronchodilator. This could lead to an increased incidence of cardiovascular and central nervous system side effects that can occur with the use of these types of bronchodilators.

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4.

A client is taking famotidine (Pepcid) asks the home care nurse what would be the best medication to take for a headache. The nurse tells the client that it would be best to take:

A.

Aspirin (acetylsalicylic acid. ASA)
B.

Ibuprofen (Motrin)
C.

Acetaminophen (Tylenol)
D.

Naproxen (Naprosyn)

Correct Answer
C. Acetaminophen (Tylenol)

Explanation
The client is taking famotidine. a histamine receptor antagonist. This implies that the client has a disorder characterized by gastrointestinal (GI) irritation. The only medication of the ones listed in the options that is not irritating to the GI tract is acetaminophen. The other medications could aggravate an already existing GI problem.

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5.

A nurse is planning dietary counseling for the client taking triamterene (Dyrenium). The nurse plans to include which of the following in a list of foods that are acceptable?

A.

Baked potato
B.

Bananas
C.

Oranges
D.

Pears canned in water

Correct Answer
D. Pears canned in water

Explanation
Triamterene is a potassium-sparing diuretic. and clients taking this medication should be cautioned against eating foods that are high in potassium. including many vegetables. fruits. and fresh meats. Because potassium is very water-soluble. foods that are prepared in water are often lower in potassium.

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6.

A client with advanced cirrhosis of the liver is not tolerating protein well. as eveidenced by abnormal laboratory values. The nurse anticipates that which of the following medications will be prescribed for the client?

A.

Lactulose (Chronulac)
B.

Ethacrynic acid (Edecrin)
C.

Folic acid (Folvite)
D.

Thiamine (Vitamin B1)

Correct Answer
A. Lactulose (Chronulac)

Explanation
The client with cirrhosis has impaired ability to metabolize protein because of liver dysfunction. Administration of lactulose aids in the clearance of ammonia via the gastrointestinal (GI) tract. Ethacrynic acid is a diuretic. Folic acid and thiamine are vitamins. which may be used in clients with liver disease as supplemental therapy.

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7.

A female client tells the clinic nurse that her skin is very dry and irritated. Which product would the nurse suggest that the client apply to the dry skin?

A.

Glycerin emollient
B.

Aspercreame
C.

Myoflex
D.

Acetic acid solution

Correct Answer
A. Glycerin emollient

Explanation
Glycerin is an emollient that is used for dry. cracked. and irritated skin. Aspercreme and Myoflex are used to treat muscular aches. Acetic acid solution is used for irrigating. cleansing. and packing wounds infected by Pseudomonas aeruginosa.

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8.

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

Correct Answer
B. To rise slowly from a lying to a sitting position

Explanation
Accupril is an angiotensin-converting enzyme (ACE) inhibitor. It is used in the treatment of hypertension. The client should be instructed to rise slowly from a lying to sitting position and to permit the legs to dangle from the bed momentarily before standing to reduce the hypotensive effect. The medication does not need to be taken with meals. It may be given without regard to food. If nausea occurs. the client should be instructed to take a non cola carbonated beverage and salted crackers or dry toast. A full therapeutic effect may be noted in 1 to 2 weeks.

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9.

Auranofin (Ridaura) is prescribed for a client with rheumatoid arthritis. and the nurse monitors the client for signs of an adverse effect related to the medication. Which of the following indicates an adverse effect?

A.

Nausea
B.

Diarrhea
C.

Anorexia
D.

Proteinuria

Correct Answer
D. Proteinuria

Explanation
Auranofin (Ridaura) is a gold preparation that is used as an antirheumatic. Gold toxicity is an adverse effect and is evidenced by decreased hemoglobin. leukopenia. reduced granulocyte counts. proteinuria. hematuria. stomatitis. glomerulonephritis. nephrotic syndrome. or cholestatic jaundice. Anorexia. nausea. and diarrhea are frequent side effects of the medication.

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10.

A client has been taking benzonatate (Tessalon) as ordered. The nurse tells the client that this medication should do which of the following?

A.

Take away nausea and vomiting
B.

Calm the persistent cough
C.

Decrease anxiety level
D.

Increase comfort level

Correct Answer
B. Calm the persistent cough

Explanation
Benzonatate is a locally acting antitussive. Its effectiveness is measured by the degree to which it decreases the intensity and frequency of cough. without eliminating the cough reflex.

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