Pharm NCLEX Style Questions Test 1

A client presents to the clinic reporting ringing in the ears and difficulty hearing. What medication in the client's current regimen should the nurse suspect? a. Hydrochlorothiazide b. Acetaminophen with codeine c. Insulin d. Erythromycin

d. Erythromycin macrolide antibiotics such as erythromycin can cause severe auditory nerve damage manifested by these symptoms

The nurse is reviewing a client's health history and medication administration record. What drug would most likely induce the effects of the cytochrome P450 enzyme system? a. Quinidine b. Mexiletine c. Ketoconazole d. Prednisone

d. Prednisone Rationale: nicotine, alcohol, and glucocorticoids such as prednisone induce the effects of the P450 enzyme system Ketoconazole, quinidine, and mexiletine inhibit the effects

After reviewing class material about the natural sources of drugs, the students demonstrate understanding of the material when they identify what as an example of a drug that is derived from inorganic compounds? a. penicillin b. codeine c. insulin d. aluminum hydroxide

d. aluminum hydroxide

A client has developed a tolerance to a drug. How should the nurse address this when providing care? a. assess the client for signs and symptoms of an allergy to the drug b. assess the client for signs and symptoms of adverse drug effects c. advocate for a change in the client's medication d. assess whether the client needs larger doses to achieve the effect

d. assess whether the client needs larger doses to achieve the effect

A nurse is to administer a new drug to a client. The entry in the nursing drug guide states that the drug is loosely bound to protein. The nurse should recognize what implication of this drug characteristic? a. the drug will be released very slowly b. there is an increased risk of drug-drug interactions c. the drug's rate of excretion will be relatively slow d. the drug will have a short duration of action

d. the drug will have a short duration of action

A nurse is teaching a client about the pharmacotherapeutics of the hormone replacement therapy that he has been prescribed. What topic should the nurse address? a. the way the client's body processes hormones b. safe and effective methods for drug administration c. the processes of absorption and elimination d. the effect of the drug on the client's body

d. the effect of the drug on the client's body

What client may be receiving a drug from an animal-plant source? A client: a. with heart failure who is prescribed digitalis b. with type 2 diabetes who takes oral antihyperglycemics c. whose traumatic injuries are being treated with morphine d. who has been diagnosed with hypothyroidism

d. who has been diagnosed with hypothyroidism rationale: derived from an animal source but can also be created synthetically

A drug has been tested on laboratory animals and is now ready for the next phase. What does the nurse identify this next step as? a. Phase III b. Preclinial trial c. Phase II d. Phase I

D. Phase 1

Drugs that are highly lipid soluble are more likely to pass through the blood-brain barrier and reach the central nervous system (true or false)

True

Most oral drugs are best taken on an empty stomach (true or false)

True

The nurse is assessing a client who has been taking direct-acting cholinergic agonists. What assessment finding should the nurse attribute to this medication? a. heart rate 62 bpm b. blood pressure 121/68 mm Hg c. Drowsiness d. three bowel movements over the past 4 days

a. Heart rate 62 bpm

A drug has been approved by the FDA. What is the next step in the process? a. Phase IV b. Phase I c. Phase III d. Phase II

a. Phase IV

A client's drug level has reach critical concentration. What action should the nurse perform? a. assess for evidence of the expected therapeutic effects b. assess for signs of delayed drug excretion c. perform an emergency assessment d. assess for indications of impaired metabolism

a. assess for evidence of the expected therapeutic effects Rationale: the amount of a drug that is needed to cause a therapeutic effect is called the critical concentration

How does knowledge of a drug's adverse effects impact the care provided by the nurse? Select all that apply. a. baseline can be established to help identify adverse effects that occur b. assessments include monitoring for expected or common adverse effects c. drug teaching can address s/sx the client should be alerted for d. decisions can be made about whether or not to administer drug e. adverse effects can be avoided through interventions made before giving the drug

a. b., and c.

A 22-year-old man has been accepted as a participant in a drug trial while his female friend of the same age was rejected. What is the most likely rationale for this decision? a. Drugs pose a risk to the woman's ova b. Risks of toxicity are slightly higher for females c. Men are less likely to experience adverse effects of the drug d. Men as a group typically have homogenous body builds and tissue mass

a. drugs pose a risk to the woman's ova

The nurse is researching a new drug's pharmacokinetics in the nursing drug guide. What information should the nurse read about? Select all that apply. a. Duration b. Drug half-life c. Receptor antagonism d. Timing of peak effect e. Selective toxicity

a. duration b. drug half-life d. timing of peak effect

A client is suspected of having a liver injury as a result of drug therapy. What lab finding would best support this diagnosis? a. elevated aspartate aminotransferase (AST) level b. elevated serum creatinine level c. sudden drops in hemoglobin, hematocrit, and red cell count d. elevated blood urea nitrogen (BUN)

a. elevated aspartate aminotransferase (AST) level

A nurse administers carbachol eye drops to a client. What finding would indicate that the drug is effective? a. miosis b. eye muscle paralysis c. ptosis d. mydriasis

a. miosis

A client develops bone marrow suppression related to a drug's effects. What is the nurse's priority action? a. monitor lab blood values b. prepare the client for dialysis c. facilitate cardiac monitoring d. place the client on protective isolation

a. monitor lab blood values

A nurse has looked up a new drug in a drug guide and is reviewing characteristics of its absorption. Which processes may be involved in this drug's absorption? Select all that apply. a. passive diffusion b. distribution c. active transport d. filtration e. protein binding

a. passive diffusion, c. active transport, d. filtration

The nurse has administered a cholinergic agent to a client. What assessment would best identify the intended therapeutic effect? a. urinary output b. weight and abdominal girth c. activity tolerance and ambulation d. lung auscultation

a. urinary output

Which client is most likely to be vulnerable to the effects of impaired drug absorption? A client: a. with IBS b. who receives peritoneal dialysis for acute kidney injury c. with ischemic heart disease d. who has HIV

a. with IBS

The nurse is caring for a client who has been admitted after an acetaminophen overdosage. Which nurse's assessment finding suggest liver damage? Select all that apply. a. elevated RBC count b. Client's temp is 102.5*F c. Client's skin and eyes are visibly jaundiced d. Client's eyes are sensitive to light e. Client's AST & ALT levels are elevated

b, c, e

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified and the client is being stabilized. What is the nurse's priority action? a. encourage the use of MedicAlert identification b. Discontinue the drug immediately as ordered c. Administer topical corticosteroids d. Administer prescribed epinephrine SQ

b. Discontinue the drug immediately as ordered

A nurse is preparing to administer morphine and recognizes morphine as belonging to what classification of controlled substance? a. Schedule IV b. Schedule II c. Schedule III d. Schedule V

b. Schedule II

The nurse is administering a drug that has selective toxicity. What effect will this have on the client? a. There is a narrow window between the therapeutic dose and a toxic dose b. The drug will affect foreign cells, but not healthy body cells c. The drug will react with specific receptor sites preventing the reaction of another chemical d. There is an unknown, but significant, risk of adverse effects

b. The drug will affect foreign cells, but not healthy body cells

Which client is experiencing an adverse effect that is a result of PRIMARY action? a. a client who develops diarrhea shortly after beginning a course of antibiotics b. a client taking anticoagulants who develops a GI bleed c. an older adult client who becomes agitated and disorientated after being given a narcotic analgesic d. a client who takes an antihistamine and falls asleep

b. a client taking anticoagulants who develops a GI bleed

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform? a. check the client's urine output b. review the client's most recent potassium level c. assess the client's level of orientation d. check the client's blood glucose level

b. review the client's most recent potassium level

The nurse is assessing a client who is in distress and may be experiencing an anaphylactic reaction. What assessment finding is most consistent with this diagnosis? a. swollen cervical lymph nodes b. shortness of breath c. sudden somnolence d. swollen joints

b. shortness of breath

The nurse is assessing numerous clients on the acute medicine unit. Which client is most likely experiencing an adverse effect from the primary action of the medication? A client: a. whose antidepressant has caused sexual dysfunction in the past b. taking antihypertensives who reports dizziness upon standing c. taking oral antibiotics who has experienced nausea after each use d. whose upper GI bleed is attributed to NSAIDs

b. taking antihypertensives who reports dizziness upon standing

A drug being test is removed from testing during a phase II study. What would be the most likely reason for such action? a. lack of participants for clinical trials b. unacceptable adverse effects c. patent violation d. likelihood of prohibitive cost

b. unacceptable adverse effects

The nurse is caring for a client who exhibits an excessive response to a secondary effect of a drug, which the nurse classifies as a hypersensitivity response. What factors can potentially contribute to a hypersensitivity reaction? Select all that apply. a. infrequent administration of the drug b. unique receptors and cellular responses c. age-related changes d. creation of antibodies e. pathological condition

b. unique receptors and cellular responses, c. age-related changes, e. pathological condition

Which client is receiving a drug that is an agonist? A client: a. whose depression is treated with a monoamine oxidase inhibitor b. who takes insulin several times daily for type 1 diabetes c. who is taking a selective serotonin-reuptake inhibitor d. who takes a beta-blocker for hypertension

b. who takes insulin several times daily for type 1 diabetes Rationale: Insulin is considered an agonist because it reacts with specific reactor sites to cause the same activity that the natural chemical would cause

A client has not experienced the desired therapeutic effects of a medication. When considering factors that may affect the dynamic equilibrium that influences drug concentration, the nurse should do what? a. review the client's electrolyte levels b. educate the client about drug-drug interactions c. assess for factors that reduce absorption d. assess the client for adverse effects

c. assess for factors that reduce absorption Rationale: reduced absorption is among the factors that contributes to the dynamic equilibrium affecting drug concentration & electrolyte levels do not have a major effect

The nurse administers a medication and the client has an immediate anaphylactic reaction following injection. What symptoms assessed by the nurse would indicate anaphylaxis? Select all that apply. a. constricted pupils b. slow heart rate c. difficulty breathing d. increased blood pressure e. diaphoresis

c. difficulty breathing, d. increased blood pressure, e. diaphoresis

A client is receiving antibiotics for treatment of infection. The nurse should assess for what potential indications of superinfection? Select all that apply. a. epistaxis b. joint pain c. glossitis d. fever e. difficulty swallowing

c. glossitis, d. fever

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose 1 hour after that. The nurse's assessment should focus on the possibility of: a. anaphylaxis b. hypersensitivity c. poisoning d. allergies

c. poisoning

The nurse is caring for a client who is receiving an anti-diabetic agent. What assessment finding should the nurse attribute to a possible adverse reaction? a. the client states, "I just can't seem to quench my thirst." b. The client has voided three times in the past hour. c. The client reports feeling unusually drowsy and fatigued. d. the nurse's assessment reveals Kussmaul respirations.

c. the client reports feeling unusually drowsy and fatigued.