Pharmacology Exam #3

26. The nurse is caring for the client diagnosed with Type 2 Diabetes. The client is complaining of a headache, jitteriness, nervousness, sweating, and confusion. Which interventions should the nurse implement? Select all that Apply. A. Check the client's blood glucose level. B. Give the client a glass of orange juice. C. Determine when the last antidiabetic medication was administered. D. Assess the client's blood pressure and apical pulse. E. Administer the prescribed insulin via sliding scale.

. Check the client's blood glucose level. B. Give the client a glass of orange juice. C. Determine when the last antidiabetic medication was administered. D. Assess the client's blood pressure and apical pulse.

5. The client with chronic reactive airway disease is taking zafirlukast (medication similar to montelukast or Singulair). What statement by the client warrants an intervention by the nurse? A. "I have been having a yellowish appearance to my sclera lately." B. "I have started taking Tylenol every day." C. "I keep this medication up on a very high shelf." D. "I must protect this medication from extreme temperatures."

A. "I have been having a yellowish appearance to my sclera lately."

21. The nurse is discussing storage of insulin vials with the client. Which statement indicates the client understands the teaching concerning the home storage of insulin? A. "I will keep my unopened vials of insulin in the refrigerator." B. "I can keep my insulin in the trunk of my car so I will have it at all times." C. "It is all right to put my unopened insulin vials in the freezer." D. "If I prefill my insulin syringes, I must use them within 1-2 days."

A. "I will keep my unopened vials of insulin in the refrigerator."

9. Which information should the nurse teach the client who is prescribed a beclomethasone (Qvar) inhaler: A. Advise the client to gargle with water after each administration. B. Instruct the client to use the inhaler on a PRN basis. C. Encourage the client to not use a spacer when using the inhaler. D. Teach the client to check his or her forced expiratory volume daily.

A. Advise the client to gargle with water after each administration.

18. The nurse administered 12 units of Lispro insulin to the patient with Type 1 Diabetes at 0700. Which meal prevents the client from experiencing hypoglycemia? A. Breakfast. B. Lunch. C. Supper. D. HS (at bedtime) snack.

A. Breakfast.

31. Which complication should the nurse assess for in the elderly client newly diagnosed with hypothyroidism who has been prescribed levothyroxine (Synthroid). A. Cardiac dysrhythmias. B. Respiratory depression. C. Paralytic ileus. D. Thyroid storm.

A. Cardiac dysrhythmias.

36. The client diagnosed with hyperthyroidism is prescribed propylthiouracil. Which interventions should the nurse implement? Select all the Apply. A. Monitor the client's thyroid function test. B. Monitor the client's weight. C. Monitor the client for severe gastrointestinal distress. D. Monitor the client's vital signs. E. Monitor the client for activity intolerance.

A. Monitor the client's thyroid function test. B. Monitor the client's weight. C. Monitor the client for severe gastrointestinal distress. D. Monitor the client's vital signs. E. Monitor the client for activity intolerance.

25. The client with Type 2 Diabetes is admitted into the medical department with a wound on the left leg that will not heal. The healthcare provider prescribes sliding-scale insulin. The client tells the nurse, "I don't want to have to take shots. I take pills at home." Which statement is the nurse's best response? A. "If you can't keep your glucose under control with pills, you must take insulin." B. "You should discuss the insulin order with your healthcare provider because you don't want to take it." C. "You are worried about having to take insulin. I will sit down and we can talk." D. "During an illness, you may need to take insulin to help keep your blood glucose level within a more therapeutic range."

D. "During an illness, you may need to take insulin to help keep your blood glucose level within a more therapeutic range."

10. The 28-year-old female client with asthma is taking zafirlukast. What statement by the client indicates the client teaching is effective? A. "I will not drink coffee, tea, or any type of cola drinks." B. "I will take this medication at the beginning of an asthma attack." C. "It is all right to take this medication if I am trying to get pregnant." D. "I should not decrease the dose or suddenly stop taking this medication."

D. "I should not decrease the dose or suddenly stop taking this medication."

38. The client with coronary artery disease is prescribed cholestyramine. Which intervention should the nurse implement when administering the medication? A. Administer the medication with fruit juice. B. Instruct the client to decrease fiber when taking the medication. C. Monitor the cholesterol level before giving the medication. D. Assess the client for upper-abdominal discomfort.

D. Assess the client for upper-abdominal discomfort.

33. The nurse is discussing the medication levothyroxine (Synthroid) with the client diagnosed with hypothyroidism. Which intervention should the nurse discuss with the client? A. Encourage the client to decrease the fiber in the diet. B. Discuss the need to monitor the T3, T4 levels daily. C. Tell the client to take the medication with food only. D. Instruct the client to report any significant weight changes.

D. Instruct the client to report any significant weight changes.

22. Which statement best describes the pharmacodynamics of insulin? A. Insulin causes the pancreas to secrete glucose into the bloodstream. B. Insulin is metabolized by the liver and muscle and excreted in the urine. C. Insulin is needed to maintain colloidal osmotic pressure in the bloodstream. D. Insulin lowers blood glucose by promoting use of glucose in the body cells.

D. Insulin lowers blood glucose by promoting use of glucose in the body cells.

27. The client newly diagnosed with Type 2 Diabetes who has been prescribed an oral hypoglycemic medication calls the clinic and tells the nurse that his sclera has a yellow color. Which intervention should the clinic nurse implement? A. Ask the client if he has been exposed to someone with hepatitis. B. Determine if the client has a history of alcohol use or is currently drinking alcohol. C. Check to see if the client is taking digoxin. D. Make an appointment for the client to come to the healthcare provider's office.

D. Make an appointment for the client to come to the healthcare provider's office.

14. The nurse is preparing to administer the following medications. Which client should the nurse question administering the medication to? A. The client receiving hydrocortisone who has a glucose level of 100 mg/dL. B. The client receiving ceftriaxone (Rocephin) who has a WBC of 15,000. C. The client receiving heparin who has a PTT of 68 seconds. D. The client receiving a beclomethasone inhaler who is having an asthma attack.

D. The client receiving a beclomethasone inhaler who is having an asthma attack.

32. The client with hyperthyroidism is prescribed propylthiouracil (PTU). Which laboratory data should the nurse monitor? A. The client's arterial blood gases. B. The client's serum potassium level. C. The client's red blood cell (RBC) count. D. The client's white blood cell (WBC) count.

D. The client's white blood cell (WBC) count.

2. The nurse is discharging a client diagnosed with COPD. Which discharge instructions should the nurse provide regarding the client's prescription for prednisone (medication similar to hydrocortisone)? A. Take all the prednisone as ordered and stop when you are feeling better. B. Take the prednisone on an empty stomach with a full glass of water. C. Stop taking the prednisone if a noticeable weight gain occurs. D. The medication should not be abruptly discontinued.

D. The medication should not be abruptly discontinued.

37. The client diagnosed with coronary artery disease is prescribed atorvastatin (Lipitor). Which statement by the client warrants the nurse to notify the healthcare provider? A. "I really haven't changed my diet, but I am taking my mediation every day." B. "I am feeling pretty good except I am having muscle pain all over my body." C. "I am swimming at the local pool about three times a week for 30 minutes." D. "I am taking this medication first thing in the morning with a bowl of oatmeal."

B. "I am feeling pretty good except I am having muscle pain all over my body."

35. The client diagnosed with hyperthyroidism is prescribed propylthiouracil (PTU). Which statement by the client warrants immediate intervention by the nurse? A. "I seem to be drowsy and sleepy all the time." B. "I have a sore throat and I have had a fever." C. "I have gained 2 lbs since I started taking PTU." D. "Since taking PTU, I am not as hot as I used to be."

B. "I have a sore throat and I have had a fever."

40. A client with allergies is prescribed fexofenadine (Allegra). Which statement indicates the client understands the teaching concerning this medication? A. "If I get any ringing in my ears, I should notify my healthcare provider." B. "I should not become drowsy when I take this medication." C. "It is not uncommon to get a buffalo hump or moon face." D. "I will have to taper off the medications when I quit taking them."

B. "I should not become drowsy when I take this medication."

11. The 6-year-old child is experiencing an acute exacerbation of asthma. The child is using his accessory muscles to breathe and the parents transported the child to the emergency department. Which intervention should the nurse implement first? A. Administer subcutaneous epinephrine via a tuberculin syringe. B. Administer a beta2-adrenergic agonist via a nebulizer. C. Administer intravenous methylprednisolone. D. Prepare the patient for intubation and mechanical ventilation.

B. Administer a beta2-adrenergic agonist via a nebulizer.

16. The nurse administered 25 units of Humulin N (NPH) to a client with Type 1 Diabetes at 1600 (4:00pm). Which intervention should the nurse implement? A. Assess the client for hypoglycemia around 1800 (6:00pm). B. Ensure the client eats the nighttime (HS) snack. C. Check the client's serum blood glucose level. D. Serve the client the supper tray.

B. Ensure the client eats the nighttime (HS) snack.

19. The client diagnosed with Type 1 Diabetes, who is showing symptoms of diabetic ketoacidosis, complains of dry mouth, extreme thirst, and increased urination. Which intervention should the nurse expect to implement? A. Administer one amp of intravenous 50% glucose. B. Prepare to administer intravenous regular insulin. C. Inject Humulin N (NPH) subcutaneously in the abdomen. D. Hang an intravenous infusion of Dextrose 10% in Water at a keep open rate.

B. Prepare to administer intravenous regular insulin.

28. The client is scheduled for a bilateral adrenalectomy for Cushing's disease. Which information regarding the prescribed hydrocortisone should the nurse teach? Select all the Apply. A. When discontinuing this medication, it does not have to be tapered. B. Take the medication regularly; do not skip doses. C. Stop taking the medication if you develop a round face. D. Notify the healthcare provider if you start feeling an increase in thirst, have increased hunger, or increase in urination. E. Wear a MedicAlert bracelet in case of an emergency.

B. Take the medication regularly; do not skip doses. D. Notify the healthcare provider if you start feeling an increase in thirst, have increased hunger, or increase in urination. E. Wear a MedicAlert bracelet in case of an emergency.

30. The client diagnosed with hypothyroidism is prescribed levothyroxine (Synthroid). Which assessment data supports that the client needs to take more of the medication? Select all that Apply. A. The client has a 2-kg weight loss. B. The client complains of being too cold. C. The client has exophthalmos. D. The client's radial pulse rate is 90 bpm. E. The client complains of being constipated.

B. The client complains of being too cold. E. The client complains of being constipated.

29. The client has developed Cushing's syndrome as a result of long-term hydrocortisone steroid therapy. Which assessment finding supports the long-term use of steroids? A. The client is short of breath on exertion and has pale mucous membranes. B. The client has a round face and multiple ecchymotic areas on the arms. C. The client has pink, frothy sputum and jugular vein distention. D. The client has petechiae on the trunk and sclerosed veins.

B. The client has a round face and multiple ecchymotic areas on the arms.

39. Which data indicates to the nurse that atorvastatin (Lipitor) is effective? A. The client's blood pressure is 132/80 mmHg. 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.

B. The client's cholesterol level is 180 mg/dL.

15. The client with an acute exacerbation of asthma is being treated with asthma medications. Which assessment data indicates that the medications are effective? Select all the Apply. A. The client has bilateral wheezing. B. The client's lungs are clear. C. The client's pulse oximetry reading is 98%. D. The client has no peripheral clubbing. E. The client has no shortness of breath.

B. The client's lungs are clear. C. The client's pulse oximetry reading is 98%. E. The client has no shortness of breath.

7. Which assessment data indicates the client with asthma has "good" control with the medication regimen? A. The client's peak expiratory flow rate (PEFR) is 5% of his or her personal best. B. The client's lungs remain clear bilaterally, both anterior and posterior. C. The client has only had three acute exacerbations of asthma in the last week. D. The client's monthly serum theophylline level is 18 mcg/mL. E. The client is taking the medication as directed by the health-care provider.

B. The client's lungs remain clear bilaterally, both anterior and posterior.

12. The child with an acute asthma attack is prescribed a 7-day course of hydrocortisone. The mother asks the nurse, "Doesn't this medication cause serious side effects?" Which statement is the nurse's best response? A. "Yes, this medication does have serious side effects, but your child needs the medication." B. "The doctor would not have ordered a medication that has serious side effects." C. "A short-term course of steroids will not cause serious side effects." D. "There may be serious side effects if your child takes the medication for a long time."

C. "A short-term course of steroids will not cause serious side effects."

17. The nurse is teaching a client with newly diagnosed Type 1 Diabetes about insulin therapy. Which statement indicates the client needs more teaching concerning insulin therapy? A. "If I have a headache or start getting nervous, I will drink some orange juice." B. "If I pass out at home, a family member should give me a glucagon injection." C. "Because I am taking my insulin daily, I do not have to adhere to a diabetic diet." D. "I will check my blood glucose with my glucometer every day." E. "I should administer my insulin into my abdomen for best absorption."

C. "Because I am taking my insulin daily, I do not have to adhere to a diabetic diet."

1. The female client asks the nurse why her teenage child would have many boxes of pseudophedrine (Sudafed) in her room. Which statement is the nurse's best response? A. "Has your child always had allergy problems?" B. "Teenagers will try to take care of their own health problems." C. "Has the teenager's behavior at school or at home changed recently?" D. "Remove the medication and say nothing to the teenager about it."

C. "Has the teenager's behavior at school or at home changed recently?"

23. The client diagnosed with Type 2 Diabetes is prescribed glyburide. Which statement by the client warrants intervention by the nurse? A. "I have to eat my diabetic diet even if I am taking this medication." B. "I will need to check my blood glucose level at least once a day." C. "I usually have one glass of wine with my evening meal." D. "I do not like to walk every day, but I will if it will help my diabetes."

C. "I usually have one glass of wine with my evening meal."

13. The client with asthma asks the nurse, "Why should I take the corticosteroid inhaler instead of PO hydrocortisone?" Which statement by the nurse is most appropriate? A. The lungs are incapable of utilizing hydrocortisone to decrease inflammation." B. "The inhaler costs less than the hydrocortisone, which is why it should be used." C. "The inhaler will not cause the systemic problems that hydrocortisone does." D. "Hydrocortisone is not on your insurance formulary and the inhaler is."

C. "The inhaler will not cause the systemic problems that hydrocortisone does."

8. The client with an acute exacerbation of asthma is prescribed an albuterol nebulizer treatment. Which statement best describes how a nebulizer works? A. Nebulizers are small, handheld pressurized devices that deliver a measured dose of albuterol with activation. B. A nebulizer is an inhaler that delivers albuterol in the form of a dry, micronized power directly to the lungs. C. A nebulizer is a small machine used to convert albuterol solution into a mist that is delivered through a mouthpiece. D. Nebulizers are small devices that are used to crush glucocorticoids so that the client can place them under the tongue for better absorption.

C. A nebulizer is a small machine used to convert albuterol solution into a mist that is delivered through a mouthpiece.

3. The client diagnosed with COPD is prescribed the intravenous medication methylprednisolone (Solu-Medrol), which is in the same family as hydrocortisone. Which laboratory test should the nurse monitor? A. Thyroid Stimulating Hormone. B. Hemoglobin and Hematocrit. C. Blood glucose. D. Lipid Panel.

C. Blood glucose.

4. Which information should the nurse discuss with the client diagnosed with reactive airway disease who is prescribed theophylline? A. Instruct the client to take the medication on an empty stomach. B. Explain that an increased heart rate and irritability are expected side effects. C. Discuss the need to avoid large amounts of caffeine-containing drinks. D. Tell the client to double the next dose if a dose is missed.

C. Discuss the need to avoid large amounts of caffeine-containing drinks.

6. The client with asthma is using an albuterol inhaler. Which intervention should the nurse implement? A. Instruct the client to take the dose a few hours before bedtime. B. Teach the client to decrease fluid intake when taking this medication. C. Have the client demonstrate the correct way to use the inhaler. D. Encourage the client to take the medication with an antacid.

C. Have the client demonstrate the correct way to use the inhaler.

34. The nurse is discussing levothyroxine (Synthroid) with a client diagnosed with hypothyroidism. Which intervention should be included in the client teaching? A. Discuss the importance of not using iodized salt. B. Explain the importance of not the taking medication with grape juice. C. Instruct the client to take the medication in the morning. D. Teach the client to monitor daily glucose levels.

C. Instruct the client to take the medication in the morning.

24. Which statement best describes the scientific rationale for prescribing metformin (Glucophage)? A. This medication decreases insulin resistance, improving blood glucose control. B. This medication allows the carbohydrates to pass slowly through the large intestine. C. This medication will decrease the hepatic production of glucose from stored glycogen. D. This medication stimulates beta cells to release more insulin into the bloodstream.

C. This medication will decrease the hepatic production of glucose from stored glycogen.

20. The nurse in the medical department is preparing to administer Lispro insulin to a client diagnosed with Type 1 Diabetes. Which intervention should the nurse administer? A. The client does not need to wear a MedicAlert bracelet. B. Administer the dose according to the regular insulin intravenous protocol. C. Assess the client for hyperosmolar, hyperglycemic, nonketotic coma. D. Make sure the client eats the food on the meal tray that is at the bedside.

Make sure the client eats the food on the meal tray that is at the bedside.