Pharmacology M/C NCLEX-RN review questions

A nurse asks a client to discuss the way medications will be taken at home. Which phase of the nursing process is the nurse using? a. Assessment b. Planning c. Implementation d. Evaluation

b

The nurse is assisting the older adult diagnosed with a gastric ulcer to schedule her medication administration. What would be the most appropriate time for this client to take her lansoprazole (Prevacid)? 1. About 30 minutes before her morning meal. 2. At night before bed. 3. After fasting at least 2 hours. 4. 30 minutes after each meal

1

The most frequent infections causes of death are:

influenza and pneumonia

A 15 year-old adolescent with a history of diabetes is treated in the emergency department for complications related to skipping her medication for diabetes. She confides in the nurse that she deliberately skipped some of her medication doses because she did not want to gain weight and she is afraid of needle marks. Before establishing a diagnosis of "Noncompliance," what should the nurse assess? 1. Whether the patient received adequate teaching related to her medication and expresses an understanding of that teaching. 2. Whether the patient was encouraged to skip her medication by a family member or friend. 3. Whether the patient is old enough to understand the consequences of her actions. 4. Whether the provider will write another prescription because the patient refused to take the medication the first time.

1

A 24 year-old client reports taking acetaminophen (Tylenol) fairly regularly for headaches. The nurse knows that a client who consumes excess acetaminophen per day or regularly consumes alcoholic beverages should be observed for what adverse effect? 1. Hepatic toxicity 2. Renal damage 3. Thrombotic effects 4. Pulmonary damage

1

A client is receiving cholestyramine (Questran) for elevated low-density lipoprotein (LDL) levels. As the nurse completes the nursing care plan, which of the following adverse effects will be included for continued monitoring? 1. Abdominal pain 2. Orange-red urine and saliva 3. Decreased capillary refill time 4. Sore throat and fever

1

A patient has an order for a tetracycline antibiotic and has been instructed to avoid taking the medication with foods, beverages, or drugs that contain calcium, iron, or magnesium. The patient takes the antibiotic along with a daily multivitamin, not realizing that the vitamin contains iron. What effect may this have on the tetracycline? 1. Impaired absorption. 2. Increased distribution. 3. Decreased metabolism. 4. Impaired excretion.

1

Simethicone (Gas-X, Mylicon) may be added to some medications or given plain for what therapeutic effect? 1. Decrease the amount of gas associated with GI disorders. 2. Increase the acid-fighting ability of some medications. 3. Prevent constipation associated with GI drugs. 4. Prevent diarrhea associated with GI drugs.

1

The nurse is administering medications and the client states, "I've never seen that blue pill before." What would be the nurse's appropriate action? 1. Verify the order and double-check the drug label. 2. Administer the medication in the existing form. 3. Instruct the client that different brands are frequently used and may account for the change of color. 4. Recommend that the client discuss the medication with the provider and give the medication.

1

The provider has orderd atropine, a drug that will prevent the patient's own chemical, acetylcholine, from causing parasympathetic effects. What type of drug would atropine be considered? 1. An antagonist 2. A partial agonist 3. An agonist 4. A protagonist

1

What is the term used to describe the magnitude of maximal response that can be produced from a particular drug? 1. Efficacy 2. Toxicity 3. Potency 4. Comparability

1

The nurse is caring for a client with gastroesophageal reflux disease (GERD) and would question an order for which of the following? 1. Amoxicillin (Amoxil) 2. Ranitidine (Zantac) 3. Pantoprazole (Protonix) 4. Calcium carbonate (Tums)

1 (Antibiotics such as Amoxicillin (amoxil) are used in the treatment of peptic ulcers caused by h.pylori. They are not indicated for the treatment of GERD.)

A client has been on long-term therapy with colestipol (Colestid). To prevent adverse effects related to the length of therapy and lack of nutrients, which of the following supplements may be required? (Select all that apply.) 1. Folic acid 2. Vitamins A, D, E, and K 3. Potassium, iodine, and chloride 4. Protein 5. B Vitamins

1, 2

A client is diagnosed with tuberculosis and is prescribed Rifater (combination of pyrazinamide with isoniazid and rifampin). While the client is on this medication, what teaching is essential? (Select all that apply.) 1. "It is critical to continue therapy for at least 6 to 12 months." 2. "Two or more drugs are used to prevent tuberculosis bacterial resistance." 3. "These drugs may also be used to prevent tuberculosis." 4. "No special precautions are required" 5. "After 1 month of treatment, the medication will be discontinued."

1, 2, 3

Metronidazole (Flagyl) is being used to treat a client's Gardia lamblia infection, a protozoal infection of the intestines. Which of the following are appropriate to teach this client? (Select all that apply.) 1. Metronidazole may leave a metallic taste in the mouth. 2. The urine may turn dark amber brown while on the medication. 3. The metronidazole may be discontinued once the diarrhea subsides to minimize adverse effects. 4. Taking the metronidazole with food reduces GI upset. 5. Current sexual partners do not require treatment for this infection.

1, 2, 4, 5

A client has been diagnosed with genital herpes and has been started on oral acyclovir (Zovirax). What should be included in the teaching instructions for this client? (Select all that apply.) 1. Increase fluid intake up to 2 L per day. 2. Report any dizziness, tremors,or confusion. 3. Decrease the amount of fluids taken so that the drug can be more concentrated. 4. Take the drug only when having the most itching or pain from the outbreak. 5. Use barrier methods such as condoms for sexual activity.

1, 2, 5

The nurse administers a medication to the wrong client. What are the appropriate nursing actions required? (Select all that apply.) 1. Monitor the client for adverse reactions. 2. Document the error if the client has an adverse reaction. 3. Report the error to the health care provider. 4. Notify the hospital legal department of the error. 5. Document the error in a critical incident/occurrence report.

1, 3, 5

What is the role of the nurse in medication administration? (Select all that apply). 1. Ensure that all medications are administered and delivered in a safe manner. 2. Be certain that health care provider orders are accurate. 3. Inform the patient that prescribed medications need to be taken only if the patient agrees with the treatment plan. 4. Ensure that the patient understands the use and administration technique for all prescribed medications. 5. Prevent adverse drug reactions by properly administering all medications.

1, 4

A patient with cirrhosis of the liver exhibits decreased metabolic activity. This will require what possible changes? (Select all that apply.) 1. A reduction in the dosage of the drugs. 2. A change in the timing of medication administration. 3. An increased dose of prescribed drug. 4. Giving all prescribed drugs by intramuscular injection. 5. More frequent monitoring for adverse drug effects.

1, 5

A client will be discharged after surgery with a prescription for penicillin. When planning at home instructions, what will the nurse include? 1. Penicillin can be taken while breastfeeding. 2. The entire prescription must be finished. 3. All penicillins can be taken without regard to eating. 4. Some possible side effects include abdominal pain and constipation.

2

A client with a severe systemic fungal infection is to be given amphortericin B (Fungizone). Before starting the amphortericin infusion, the nurse premedicates the client with acetaminophen (Tylenol), diphenhydramamine (Benadryl), and prednisone (Deltasone). What is the purpose of premedicating the client prior to the amphortericin? 1. It delays the development of resistant fungal infections. 2. It decreases the risk of hypersensitivity reactions to the amphortericin. 3. It prevents hyperthermia reactions from the amphortericin. 4. It works synergistically with the amphortericin so a lower dose may be given.

2

A 32 year old female has been started on amoxicillin (AAmoxil, Trimox) for a severe UTI. Before sending her home with this prescription, the nurse will provide which instruction? 1. Teach her to wear sunscreens. 2. Ask her about oral contraceptive use and recommend an alternative method for the duration of the ampicillin course. 3. Assess for hearing loss. 4. Recommend taking the pill with some antacid to prevent GI upset.

2

A client is started on efavirenz (Sustiva) for HIV. What should the nurse teach the client about this drug? 1. Efavirenz (Sustiva) will cure the disease over time. 2. Efavirenz (Sustiva) will not cure the disease but may significantly extend the life expectancy. 3. Efavirenz (Sustiva) will be used to prior to vaccines. 4. Efavirenz (Sustiva) will prevent the transmission of the disease.

2

A client with significant hypertension unresponsive to other medications is given a prescription for hydralazine (Apresoline). An additional prescription of propranolol (Inderal) is also given to the client. The client inquires why two drugs are needed. What is the nurses best response? 1. Giving the two drugs together will lower the BP even more than just one alone. 2. They hydralazine may cause tachycardia and the propranolol will help keep the heart rate within normal limits. 3. The propranolol is to prevent lupus erythematosus from developing. 4. Direct-acting vasodilators such as hydralazine cause fluid retention and the propranolol will prevent excessive fluid buildup.

2

A client with type 2 diabetes treated with oral antidiabetic medication is receiving oral fluconazole (Diflucan) for treatment of chronic tinea cruris (jock itch). The nurse instructs the client to monitor blood glucose levels more frequently because of what potential drug effect? 1. Fluconazole (Diflucan) antagonizes the effects of many antidiabetic medications, causing hyperglycemia. 2. Fluconazole (Diflucan) interacts with certain antidiabetic drugs, causing hypoglycemia. 3. Fluconazole (Diflucan) causes hyperglycemia. 4. Fluconazole (Diflucan) causes hypoglycemia.

2

A patient experiences profound drowsiness when a stimulant drug is given. This is an unusual reaction for this drug, a reaction that has not been associated with that particular drug. What is the term for this type of drug reaction? 1. Allergic reaction 2. Idiosyncratic reaction 3. Enzyme-specific reaction 4. Unaltered reaction

2

A patient has a malignant brain tumor. What pharmacokinetic phase may be affected by the presence of the tumor? 1. Absorption 2. Distribution 3. Metabolism 4. Excretion

2

Nifedipine (Procardia) has been ordered for a client with hypertension. In the care plan, the nurse includes the need to monitor for which adverse effect? 1. Rash and chills 2. Reflex tachycardia 3. Increased urinary output 4. Weight loss

2

The client is taking atenolol (Tenormin) and doxazosin (Cadura). What is the rationale for combining two anti-hypertensive drugs? 1. The blood pressure will decrease faster 2. Lower doses of both drugs may be given with fewer adverse effects. 3. There is less daily medication dosing. 4. Combination therapy will treat the patient's other medical conditions.

2

The client is to begin taking atorvastatin (Lipitor) and the nurse is providing education about the drug. Which symptom related to this drug should be reported to the health care provider? 1. Constipation 2. Increasing muscle or joint pain 3. Hemorrhoids 4. Flushing or "hot flash"

2

The health care agency is implementing the use of root-cause analysis (RCA) to reduce the occurrence of medication errors. What areas does RCA analyze in order to prevent errors from recurring? 1. Why the medication was ordered, whether it was the correct medication, and whether the client experienced therapeutic results. 2. What happened, why it happened and what can be done to prevent it from happening again. 3. What the cost of the medication was, whether it was the most appropriate medication to order or whether there is a better alternative. 4. Whether the medication was documented in the provider's orders, medication administration record, and pharmacy.

2

The nurse is preparing to administer chemothereapy to an oncology client who also has an order for ondansetron (Zofran). When should the nurse administer the ondansetron? 1. Every time the client complains of nausea 2. 30 to 60 minutes before starting chemotherapy 3. Only if the client complains of nausea 4. When the client begins to experience vomiting during the chemotherapy.

2

The nurse is teaching a community health class to a group of young adults who have recently immigrated to the United States about preventing hepatitis B (HBV). What is the most effective method of preventing an HBV infection? 1. Peginterferon alfa-2a (Pegasys) 2. HBV vaccine (Engerix-B) 3. Adefovir dipivoxil (Hepsera) 4. Entecavir (Baraclude)

2

The nurse reads that the drug to be given to the patient, has a "narrow therapeutic index." The nurse knows that this means that the drug has what properties? 1. It has a narrow range of effectiveness and may not give this patient the desired therapeutic results. 2. It has a narrow safety margin and even a small increase in dose may produce adverse or toxic effects. 3. It has a narrow range of conditions or diseases that the drug will be expected to treat successfully. 4. It has a narrow segment of the population for whom the drug will work as desired.

2

The nurse receives laboratory studies of a client receving digoxin (Lanoxin). Intervention by the nurse is required if the results include which of the following laboratory values? 1. Serum digoxin level of 1.2 ng/dL 2. Serum potassium level of 3 mEq/L 3. Hemoglobin of 14.4 g/dL 4. Serum sodium level of 140 mEq/L

2

The nurse teaches the client relaxation techniques and guided imagery as an adjunct to medication for treatment of pain. What is the main rationale for the use of these techniques as an adjunct to analgesic medication? 1. They are less costly techniques. 2. They may allow lower doses of drugs with fewer adverse effects. 3. They can be used at home. 4. They do not require self-injection.

2

The order reads, "Lasix 40 mg IV STAT." Which of the following actions should the nurse take? 1. Administer the medication within 30 minutes of the order. 2. Administer the medication within 5 minutes of the order. 3. Administer the medication as required by the patient's condition. 4. Assess the patient's ability to tolerate the medication before giving.

2

Which of the following represents an appropriate outcome established during the planning phase? 1. The nurse will teach the patient to recognize and respond to adverse effects from the medication. 2. The patient will demonstrate self-administration of the medication, using a preloaded syringe into the subcutaneous tissue of the thigh, prior to discharge. 3. The nurse will teach the patient to accurately prepare the dose of medication. 4. The patient will be able to self-manage his disease and medications.

2

Planning teaching needs for a client who is to be discharged postoperatively with a prescription for oxycodone with acetaminophen (Percocet) should include which of the following? 1. Refer the client to a drug treatment center if addiction occurs. 2. Encourage increased fluids and fiber in the diet. 3. Monitor to GI bleeding. 4. Teach the client to self-assess blood pressure.

2 (Percoset can slow peristalsis, leading to constipation)

The nurse has administered prochlorperazine (Compazine) to a client for postoperative nausea. Before administering this medication, it is essential that the nurse check which of the following? 1. Pain level 2. Blood pressure 3. Breath sounds 4. Temperature

2 (prochlorperazine-Compazine-may cause decreased BP or hypotension as an adverse effect. Drug is held if BP is below 90/60 mmHg--or parameter set by health care provider.)

The nurse is instructing a client on home use of niacin and will include important instructions on how to take the drug and about its possible adverse effects. Which of the following may be expected adverse effects of this drug? (Select all that apply.) 1. Fever and chills 2. Intense flushing and hot flashes 3. Tingling of fingers and toes 4. Hypoglycemia 5. Dry mucous membranes

2, 3 (intense flushing and hot flashes occur in almost everyone taking niacin. Tingling of fingers and toes may also occur.)

While taking the patient's admission history, the patient describes having a severe allergy to an antibiotic. What is the nurse's responsibility to prevent an allergic reaction? (Select all that apply). 1. Instruct the patient to alert all providers about the allergy. 2. Document the allergy in the medical record. 3. Notify the provider and the pharmacy of the allergy and type of allergic reaction. 4. Place an allergy bracelet on the patient. 5. Instruct the patient not to allow anyone to give the antibiotic.

2, 3, 4

The nurse is preparing to administer the first dose of enalapril (Vasotec). Identify the potential adverse effects of this medication. (Select all that apply.) 1. Reflex hypertension 2. Hyperkalemia 3. Persistent cough 4. Angioedema 5. Hypotension

2, 3, 4, 5

A client with HIV has been taking lopinavir with ritonavir (Kaletra) for the past 8 years and has noticed a redistribution of body fat in the arms, legs, and abdomen (lipodystrophy). The nurse will evaluate this client for what other additional adverse effects associated with this drug? (Select all that apply.) 1. Renal failure 2. Hyperglycemia 3. Pancreatitis 4. Bone marrow transplant 5. Hepatic failure

2, 3, 5

Which of the following medications would not be administered through a nasogastric tube? (Select all that apply). 1. Liquids 2. Enteric-coated tablets 3. Sustainted-release tablets 4. Finely crushed tablets 5. IV medications

2, 3, 5

A 35-year-old male client has been prescribed omeprazole (Prilosec) for treatment of a GERD. Which of the following assessment findings would assist the nurse to determine whether drug therapy has been effective? (Select all that apply.) 1. Decreased "gnawing" upper abdominal pain on an empty stomach. 2. Decreased belching 3. Decreased appetite 4. Decreased nausea 5. Decreased dysphagia

2, 4, 5

A client with a history of hypertension is to start drug therapy for rheumatoid arthritis. Which of the following drugs would be contraindicated, or used cautiously, for this client? (Select all that apply.) 1. Aspirin 2. Ibuprofen (Advil, Motrin) 3. Acetaminophen (Tylenol) 4. Naproxen (Aleve) 5. Methylprednisolone (Medrol)

2, 4, 5 (NSAIDS such as ibuprofen and naproxen have been shown to increase the risk of serious thromboembolic events, MI, and stroke which can be fatal. These drugs should be used cautiously or avoided in patients with HTN. Corticosteroids such as methylprednisolone may cause fluid retention, which may increase the client's BP. Aspirin or acetaminophen will not increase the client's BP.)

A client with severe diarrhea has an order for diphenoxylate with atropine (Lomotil). When assessing for therapeutic effects, which of the following will the nurse expect to find? 1. Increased bowel sounds 2. Decreased belching and flatus 3. Decrease in loose, watery stools 4. Decreased abdominal cramping

3

A 16-year old adolescent is 6 weeks pregnant. The pregnancy has exacerbated her acne. She asks the nurse if she can resume taking her isotretinoin (Accutane) prescription, a category X drug. What is the most appropriate response by the nurse? 1. "Since you have a prescription for Accutane, it is safe to resume using it." 2. "You should check with your health care provider at your next visit." 3. "Accutane is known to cause birth defects and should never be taken during pregnancy." 4. "You should reduce the Accutane dosage by half during pregnancy."

3

A client has been diagnosed with a fungal nail infection. The health care provider has prescribed griseofulvin (Fulvicin). The nurse will include which of the following in her teaching to the client? 1. Drug therapy will be for a very short time, probably 2 to 4 weeks. 2. Carefully inspect all intramuscular injection sites for bruising. 3. Notify the provider if symptoms of infection worsen. 4. Limit fluid intake to approximately 1,000 mL/day.

3

A client has been ordered gemfibrozil (Lopid) for hyperlipidemia. The nurse will first validate the order with the health care provider if the client reports a history of which disorder? 1. Hypertension 2. Angina 3. Gallbladder disease 4. Tuberculosis

3

A client with heart failure has an order for lisinopril (Prinivil, Zestril). Which of the following conditions in the client's history would lead the nurse to confirm the order with the provider? 1. A history of hypertension previously treated with diuretic therapy 2. A history of seasonal allergies currently treated with antihistamines 3. A history of angioedema after taking enalapril (Vasotec) 4. A history of alcoholism, currently abstaining

3

A female client reports using OTC aluminum hydroxide (AlternaGEL) for relief of gastric upset. She is on renal dialysis three times a week. What should the nurse teach this client? 1. Continue using the antacids but if she needs to continue beyond a few months, she should consult the health care provider about different therapies. 2. Take the antacid no longer than for 2 weeks; if it has not worked by then, it will not be effective. 3. Consult with the health care provider about the appropriate amount and type of antacid. 4. Continue to take the antacid; it is OTC and safe.

3

A patient who is in renal failure may have a diminished capacity to excrete medications. The nurse must assess the patient more frequently for what development? 1. Increased risk of allergy. 2. Decreased therapeutic drug effects. 3. Increased risk for drug toxicity. 4. Increased absorption of the drug from the intestines.

3

An older patient has arthritis in her hands and takes several prescription drugs. Which statement by this patient requires further assessment by the nurse? 1. "My pharmacist puts my pills in screw-top bottles to make it easier for me to take them." 2. "I fill my prescriptions once per month." 3. "I care for my 2 year old grandson twice a week." 4. "My arthritis medicine helps my stiff hands."

3

Before administering drugs by the enteral route, the nurse should evaluate which of the following? 1. Ability of the patient to lie supine 2. Compatibility of the drug with IV fluid 3. Ability of the patient to swallow 4. Patency of the injection port

3

During the evaluation phase of drug administration, the nurse completes which responsibilities? 1. Prepares and administers drugs correctly 2. Establishes goals and outcome criteria related to drug therapy. 3. Monitors the patient for therapeutic and adverse effects 4. Gathers data in a drug and dietary history

3

The client has been given a prescription of furosemide (Lasix) as an adjunct to treatment of hypertension and returns for a follow-up check. Which of the following is the most objective data for determining the therapeutic effectiveness for furosemide? 1. Absence of edema in lower extremities. 2. Weight loss of 6 lbs. 3. Blood pressure log notes blood pressure 120/70 mmHg to 134/88 mmHg since discharge. 4. Frequency of voiding of at least 6 times per day.

3

The client has been taking aspirin for several days for headache. During the assessment, the nurse discovers that the client is experiencing ringing in the ears and dizziness. What is the most appropriate action by the nurse? 1. Question the client about history of sinus infections. 2. Determine whether the client has mixed the aspirin with other medications. 3. Tell the client not to take any more aspirin. 4. Tell the client to take aspirin with food or milk.

3

The client is prescribed digoxin (Lanoxin) for treatment of HF. Which of the following statements by the client indicates the need for further teaching? 1. "I may notice my heart rate decrease." 2. "I may feel tired during my treatment." 3. "This drug should cure my heart failure." 4. "My energy level should gradually improve."

3

The nurse is preparing to give an oral medication to a 6-month old infant. How should this drug be administered? 1. By placing the medication in the next bottle of formula. 2. By mixing the medication with juice in a bottle. 3. By placing the medicine dropper in the inner cheek, allowing time for the infant to swallow. 4. By placing the medication toward the back of the mouth to avoid having the infant immediately spit out the medication.

3

The nurse is teaching a postoperative client about the medications ordered for use at home. Because this client also has a primary care provider in addition to the surgeon, what strategy should the nurse include in this teaching session that might prevent a medication error in the home setting? 1. Encourage the client to consult the Internet about possible side effects. 2. Delay taking any new medications prescribed by the surgeon until the next health visit with the primary provider. 3. Have all prescriptions filled at one pharmacy. 4. Insist on using only brand-name drugs because they are easier to remember than generic names.

3

What important information should be included in the client's education regarding taking ciproloxacin (Cipro)? 1. The drug can cause discoloration of the teeth. 2. Fluid intake should be decreased to prevent urine retention. 3. Any heel or lower leg pain should be reported immediately. 4. The drug should be taken with an antacid to reduce gastric effects.

3

What is the most appropriate method to ensure adequate pain relief in the immediate postoperative period from an opioid drug? 1. Give the drug only when the family members report that the client is complaining of pain. 2. Give the drug every time the client complains of acute pain. 3. Give the drug as consistently as possible for the first 24 to 48 hours. 4. Give the drug only when the nurse observes signs and symptoms of pain.

3

Which of the following findings would suggest that myelosuppression is ocuring in a client who is taking zidovudine (Retrovir)? 1. Increase in serum blood urea nitrogen (BUN) levels 2. Increase in white blood cell (WBC) count 3. Decrease in platelet count 4. Decrease in blood pressure

3

A client admitted with hepatitis B is prescribed hydrocodone with acetaminophen (Vicoden) 2 tablets for pain. What is the most appropriate action for the nurse to take? 1. Administer the drug as ordered. 2. Administer 1 tablet only. 3. Recheck the order with the health care provider. 4. Hold the drug until the health care provider arrives.

3 (acetaminophen can be hepatotoxic)

Which of the following are correct statements regarding nursing diagnoses? (Select all that apply.) 1. They identify the medical problem experienced by the patient. 2. They are identified for the patient by the nurse. 3. They identify the patient's response to actual or potential health and life processes. 4. They assist in determining nursing interventions. 5. They remain the same throughout the patient's health care encounter to ensure continuity of care.

3, 4

The nurse administers morphine sulfate 4 mg IV to a client for treatment of severe pain. Which of the following assessments require immediate nursing interventions? (Select all that apply.) 1. The client's blood pressure is 110/70 mmHg. 2. The client is drowsy. 3. The client's pain is unrelieved in 15 minutes. 4. The client's respiratory rate is 10 breaths per minute. 5. The client becomes unresponsive.

3, 4, 5

To reduce the chance of duplicate medication order for the older adult returning home after surgery, what actions should the nurse take? (Select all that apply.) 1. Call in all prescriptions to the patient's pharmacies rather than relying on paper copies of prescriptions. 2. Give all prescriptions to the patient's family members. 3. Take a medication history, including all OTC and prescription medications and a pharmacy history with each patient visit. 4. Work with the patient's health care provider to limit the number of prescriptions. 5. Perform a medication reconciliation before sending the patient home.

3, 5

Which method may offer the best opportunity for patient teaching? 1. Providing detailed written information when the client is discharged. 2. Providing the patient with Internet links to conduct research on drugs. 3. Referring the patient to external health care groups that provide patient education, such as the American Heart Association 4. Providing education about the patient's medications each time the nurse administers the drug.

4

Percentage of the world infected with TB?

32

A 32 year-old female client is started on metronidazole (Flagyl) for treatment of a trichomonas vaginal infection. What must the client eliminate from her diet for the duration she is on this medication? 1. Caffeine 2. Acidic juices 3. Antacids 4. Alcohol

4

A client has been prescribed tetracycline. When providing information regarding this drug, the nurse should include what information about tetracycline? 1. It is classified as a narrow-spectrum antibiotic with minimal adverse effects. 2. It is used to treat a wide variety of disease processes. 3. It has been identified to be safe during pregnancy. 4. It is contraindicated in children younger than 8 years.

4

A client has received a prescription for zanamivir (Relenza) for flulike symptoms. The client states, "I think I'll hold off on starting this. I don't feel that bad yet." What is the nurse's best response? 1. "The drug has a stable shelf life so you can save it for later infections." 2. "It can be saved for later but you will also require an antibiotic to treat your symptoms if you wait." 3. "It can be started within two weeks after the onset of symptoms." 4. "To be effective, it must be started within 48 hours after the onset of symptoms."

4

A client was prescribed chloroquine (Aralen) prior to a trip to an area where malaria is known to be endemic. The nurse will instruct the client to remain on the drug for up to six weeks after returning and the client asks why this is necessary. What is the nurse's best response? 1. "You may be carrying microscopic malaria parasites back with you on clothes or other personal articles." 2. "It helps prevent transmission to any of your family members." 3. "It will prevent any mosquito that bites you from picking up the malaria infection." 4. "It continues to kill any remaining malarial parasites that may have been acquired during the trip that are in your red blood cells."

4

A client with constipation is prescribed psyllium (Metamucil) by his health care provider. What essential teaching will the nurse provide to the client? 1. Take the drug with meals and at bedtime. 2. Take the drug with minimal water so that it will not be diluted in the GI tract. 3. Avoid caffeine and chocolate while taking this drug. 4. Mix the product in a full glass of water and drink another glassful after taking the drug.

4

A health care provider has written an order for digoxin for the client but the nurse cannot read whether the order is for 0.25 mg, 0.125 mg, 125 mg because there is no "zero" and the decimal point may be a "one." What action would be the best to prevent a medication error? 1. Check the dosage with a more experienced nurse. 2. Consult a drug handbook and administer the normal dose. 3. Contact the hospital pharmacist about the order. 4. Contact the health care provider to clarify the illegible order.

4

A patient with diabetes has been NPO since midnight for surgery in the morning. He usually takes an oral type 2 antidiabetic drug to control his diabetes. What would be the best action for the nurse to take concerning the administration of his medication? 1. Hold all medications as ordered. 2. Give him the medication with a sip of water. 3. Give him half the original dose 4. Contact the provider for further orders.

4

As the nurse enters a room to administer medications, the client states, "I'm in the bathroom. Just leave my pills on the table and I'll take them when I come out." What is the nurse's best response? 1. Leave them on the table as requested and check back with the client later to verify they were taken. 2. Leave the medications with the client's visitors so they can verify that they were taken. 3, Inform the client that the medications must be taken now; otherwise they must be documented as "refused." 4. Inform the client that the nurse will return in a few minutes when the client is available to take the medications.

4

In taking a new client's history, the nurse notices that he has been taking omeprazole (Prilosec) consistently over the past 6 months for treatment of epigastric pain. Which recommendation would be the best for the nurse to give this client? 1. Try switching to a different form of the drug 2. Try a drug like cimetidine (Tagamet) or famotidine (Pepcid). 3. Try taking the drug after meals instead of before meals. 4. Check with his health care provider about his continued discomfort.

4

Superinfections are an adverse effect common to all antibiotic therapy. Which of the following best describes a superinfection? 1. An initial infection so overwhelming that it requires multiple antimicrobial drugs to treat successfully. 2. Bacterial resistance that creates infections that are difficult to threat and that are often resistant to multiple drugs. 3. Infections requiring high-dose antimicrobial therapy with increased chance of organ toxicity. 4. The overgrowth of normal body flora or of opportunistic organisms such as viruses and yeast no longer held in check by normal beneficial flora.

4

The community health nurse is working with a client taking simvastatin (Zocor). Which client statement may indicate the need for further patient teaching about this drug? 1. "I'm trying to reach my ideal body weight by increasing my exercise." 2. "I didn't have any symptoms even though I had high lipid levels. I hear that's common." 3. "I've been taking my pill before my dinner." 4. "I take my pill with grapefruit juice. I've always taken my medications this way."

4

The emergency department nurse is caring for a client with a migraine headache. Which drug would the nurse anticipate administering to abort the client's migraine attack? 1. Morphine 2. Propranolol (Inderal) 3. Ibuprofen (Motrin) 4. Sumatripan (Imitrex)

4

The nurse is admitting a client with rheumatoid arthritis. The client has been taking prenisone (Aristospan) for an extended time. During the assessment, the nurse observes that the client has a very round moon-shaped face, bruising, and an abnormal contour of the shoulders. What does the nurse conclude based on these findings? 1. These are normal reactions with the illness. 2. These are probably birth defects. 3. These are symptoms of myasthenia gravis. 4. These are symptoms of adverse drug effects from the prednisone.

4

The nurse is counseling a mother regarding antipyretic choices for her 8-year-old daughter. When asked why aspirin is not a good drug to use, what should the nurse tell the mother? 1. It is not as good an antipyretic as is acetaminophen. 2. It may increase fever in children under age 10. 3. It may produce nausea and vomiting. 4. It increases the risk of Reye's syndrome in children under 18 with viral infections.

4

The nurse looks up butorphanol (Stadol) in a drug reference guide prior to administering the drug and notes that it is a partial agonist. What does this term tell the nurse about this drug? 1. It is a drug that produces the same type of response as the endogenous substance. 2. It is a drug that will occupy a receptor and prevent the endogenous chemical from acting. 3. It is a drug that causes unpredictable and unexplained drug reactions. 4. It is a drug that produces a weaker, or less efficacious, response than an agonist drug.

4

The patient requires a drug that is known to be completely metabolized by the first-pass effect. What change will be needed when this drug is administered? 1. The drug must be given more frequently. 2. The drug must be given in higher doses. 3. The drug must be given in a lipid-soluble form. 4. The drug must be given by a non-oral route such as parenterally.

4

The teaching plan for a client receiving hydralazine (Apresoline) should include which of the following points? 1. Returning for monthly urinalysis testing 2. Including citrus fruits, melons, and vegetables, in the diet 3, Decreasing potassium rich food in the diet 4. Rising slowly to standing from a sitting or lying position

4

To reduce the effect of a prescribed medication on the infant of a breastfeeding mother, how should the nurse teach the mother to take the medication? 1. At night 2. Immediately before the next feeding 3. In divided doses at regular intervals around the clock 4. Immediately after breastfeeding

4

What health teaching should the nurse provide for the client receiving nadolol (Corgard)? 1. Increase fluids and fiber to prevent constipation 2. Report a weight gain of 1 kg per month or more. 3. Immediately stop taking the medication if sexual dysfunction occurs. 4. Rise slowly after prolonged periods of sitting or lying down

4

What is the rationale for the administration of a loading dose of a drug? 1. It decreases the number of doses that must be given. 2. It results in lower dosages being required to achieve therapeutic effects. 3. It decreases the risk of drug toxicity. 4. It more rapidly builds plasma drug levels to a plateau level.

4

Which factor is most important for the nurse to assess when evaluating the effectiveness of a patient's drug therapy? 1. The patient's promise to comply with drug therapy 2. The patient's satisfaction with the drug 3. The cost of the medication 4. Evidence of therapeutic benefit from the medication

4

While educating the client about hydrocortisone (Cortef), the nurse would instruct the client to contact the health care provider immediately if which of the following occurs? 1. There is a decrease of 2 lb in weight. 2. There is an increase in appetite. 3. There is tearing of the eyes. 4. There is any difficulty breathing.

4

A nurse is administering a liquid medication to a 15-month old child. What is the most appropriate approach to medication administration by the nurse? (Select all that apply.) 1. Tell the child hat the medication tastes just like candy. 2. Mix the medication in 8 oz. of orange juice. 3. Ask the child if she would like to take her medication now. 4. Sit the child up, hold the medicine cup to her lips, and kindly instruct her to drink. 5. Offer the child a choice of cup in which to take the medication.

4, 5

The two most common Nursing Diagnoses for medication administration are:

Deficient knowledge and non-compliance

A client is known to be allergic to several medications. After a nurse administers a medication, an adult client's vital signs are 99.2F - 148 - 56 and BP 76/40. Which of these assessments should the nurse make? a. Allergic reaction b. Anaphylactic reaction c. Side effect d. Anticipated reaction

c

The common description of drug's duration of action in the body is considered: a. therapeutic level b. plateau of an administered drug c. plasma half-life d. drug toxicity

c

What organ of the body is the primary site of drug metabolism? a. Kidney b. Cells of the intestinal tract c. Liver d. Spleen

c

A nurse is assessing a client who is febrile. The nurse knows that the client needs an antipyretic medication. The nurse should check in which area of the MAR for this order? a. Routine orders b. STAT orders c. HS orders d. PRN orders

d

A nursing student reads in a pharmacology textbook that 10 mg of morphine is considered to provide the same pain relief as 200 mg of codeine. This indicates that the morphine would be considered more ____ than codeine.

potent