Pharmacology NCELX-PN Questions

A nurse is caring for a child with a diagnosis of diabetes insipidus. The nurse anticipates that the health care provider will prescribe which of the following medications?

Desmopressin acetate (DDAVP)

A client with Parkinson's disease is beginning treatment with carbidopa-levodopa (Sinemet). Which of the following statements made by the client indicates the need for further teaching?

"I should take my medication after a full meal."

A client is admitted to the emergency department with a diagnosis of drug-induced anxiety related to overingestion of his prescribed antipsychotic medication. The important piece of information the nurse should obtain initially is the:

Name of the ingested medication and the amount ingested.

Atropine sulfate is prescribed for a client with gastrointestinal hypermotility, and the nurse reviews the client's record before administering the medication. Which of the following, if noted on the client's record, indicates the need to contact the health care provider before administering the medication?

Narrow-angle glaucoma

A client is scheduled for subtotal thyroidectomy. Potassium iodide (Lugol solution) is prescribed. The nurse understands that the therapeutic effect of this medication is to:

Suppress thyroid hormone production.

A nurse is providing instructions to a client regarding the administration of lypressin. The nurse instructs the client that the medication will be taken by which of the following routes?

Intranasal

A nurse is reviewing laboratory results of a digoxin level for the client taking digoxin (Lanoxin). Which laboratory result would warrant health care provider notification immediately?

2.5 ng/mL

A nursing student is asked about the medication latanoprost (Xalatan) and how this medication helps glaucoma. The student responds correctly by identifying that the medication's mechanism of action is to:

Facilitate the outflow of aqueous humor.

A client newly diagnosed with gout has been prescribed allopurinol (Zyloprim). The nurse would question the health care provider if the dose for which of the following medications already prescribed has not changed?

Warfarin sodium (Coumadin)

A registered nurse (RN) asks a licensed practical nurse (LPN) to obtain a vial of mannitol (Osmitrol) for administration to a client. The LPN notes that the vial contains a few small crystals. Based on this observation, the LPN expects that the RN will:

Place the vial in warm water until the crystals dissolve.

Which information would the nurse provide to the client who will be receiving chemotherapy with doxorubicin (Adriamycin)? Select all that apply. 1. Alopecia can occur. 2. Cardiotoxicity can occur. 3. Stool may turn white. 4. Urine and sweat may turn red. 5. The medication is administered by the intravenous route. 6. Promptly report any signs of bleeding to the health care provider.

1. Alopecia can occur. 2. Cardiotoxicity can occur. 3. Stool may turn white. 4. Urine and sweat may turn red. 5. The medication is administered by the intravenous route. 6. Promptly report any signs of bleeding to the health care provider.

A child is being sent home on digoxin (Lanoxin) after being diagnosed with a congenital heart defect. The medication needs to be given once a day. Which of the following would the nurse include in her teaching plan for the family?

"Give the medication in the morning 20 to 30 minutes before a feeding."

A female client with carcinoma of the breast is admitted to the hospital for treatment with intravenous vincristine (Oncovin). The client tells the nurse that she has been told by her friends that she is going to lose all her hair. The nurse makes which appropriate response to the client?

"Hair loss may occur, and it will grow back, but it may have a different color or texture."

A client is being discharged home, and the health care provider has prescribed spironolactone (Aldactone) for the client. The nurse teaches the client about the medication. Which statement by the client would require further teaching by the nurse?

"I know I need to eat foods that are high in potassium because of the diuretic effect of the medication."

A nurse is teaching the client about insulin glargine (Lantus). The nurse determines that the client understands the action of the medication if the client makes which statement?

"I will give myself this medication subcutaneously once each night before bed."

Lispro (Humalog) insulin is prescribed three times a day, with the amount based on blood glucose levels. The nurse determines that the client understands teaching regarding lispro insulin if which of the following statements is made?

"I will take the lispro 10 to 15 minutes before I eat breakfast, lunch, and dinner."

A nurse employed in a health care provider's office is collecting data on a client who is taking ergotamine tartrate (Cafergot). The nurse evaluates the effectiveness of therapy by asking which question?

"Are the headaches relieved?"

A client with myasthenia gravis is being discharged on pyridostigmine bromide (Mestinon). The nurse provides the client with medication instructions and makes which statement to the client?

"Take the medication before activities such as eating."

A client taking an angiotensin-converting enzyme (ACE) inhibitor reviewed the medication information sheet and notes that the medication is used to treat hypertension. He states, "I have heart failure. Why am I taking this medicine?" The nurse responds by stating:

"The medication causes relaxation in your arteries and veins and decreases the heart's work."

The nurse is administering alendronate (Fosamax) to a client. What nursing intervention is most important for the nurse to consider when giving this medication? 1. Make sure the medication is taken on a full stomach. 2. Make sure the medication is taken with just a sip of water. 3. Make sure this medication is always taken at bedtime. 4. Make sure the client remains upright for 30 minutes after taking the medication.

4. Make sure the client remains upright for 30 minutes after taking the medication.

When discussing the rationale for levothyroxine (Synthroid) with a client with hypothyroidism, the nurse should emphasize that the client can anticipate what primary expected outcome?

Achieving normal thyroid hormone levels

A hospitalized client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, the nurse administers nitroglycerin, 0.4 mg sublingually. After 5 minutes, the client states, "My chest still hurts." If the vital signs have remained stable, the nurse should:

Administer another nitroglycerin tablet.

A nurse reviews the phenytoin level of a client who is taking phenytoin (Dilantin Kapseals). The nurse notes that the plasma drug level is 9 mcg/mL. Which of the following does the nurse anticipate to be prescribed for the client?

An increase in the present dosage

A nurse is caring for a client receiving digoxin (Lanoxin). The nurse monitors the client for which early manifestation of digoxin toxicity?

Anorexia

A nurse is providing dietary instructions to a client who is taking triamterene (Dyrenium). The nurse instructs the client that it is acceptable to consume which of the following food items daily?

Apple

A client receiving nifedipine (Procardia) for angina complains of feeling listless, with generalized weakness and no energy. To support the client most effectively, the nurse must understand that these symptoms:

Are an expected effect of the medication

A nurse is collecting data from a client with hypertension being treated with diuretic therapy. The nurse would monitor the client for hypokalemia if the client is receiving which diuretic?

Bumetanide

A nurse would instruct the client taking atomoxetine (Strattera) to avoid foods containing which of the following?

Caffeine

A client with breast cancer is being treated with cyclophosphamide. The nurse plans care, knowing that this medication is:

Cell cycle phase nonspecific

Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse assists in planning care, knowing that the primary action of this medication is to:

Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.

A client arrives at the health care clinic for follow-up care and evaluation of the effectiveness of prazosin (Minipress). Which finding indicates a therapeutic effect related to the use of this medication?

Decrease in blood pressure

A client with bladder cancer is receiving cisplatin and vincristine (Oncovin). The nurse plans care, knowing that the purpose of administering both of these medications is to:

Decrease medication resistance and reduce medication toxicity.

The mother of a premature baby asks the nurse why the baby is receiving a caffeine-type medication. The nurse correctly explains the use of the medication when she states it is to primarily:

Decrease the number of apnea occurrences.

Propantheline bromide (Pro-Banthine) is prescribed for a client with bladder spasms. Which of the following disorders, if noted in the client's record, alerts the nurse to question the prescription for this medication?

Glaucoma

The nurse notes that a client is being treated with nesiritide (Natrecor). The nurse would expect this client to be experiencing which disorder?

Heart failure

The nurse is providing education to the client with gestational diabetes who was recently placed on insulin therapy. The nurse tells the client that insulin needs in the second and third trimesters of pregnancy:

Increase

A nurse is monitoring a client who is receiving a dose of an adrenergic bronchodilator. The nurse plans to monitor for which side effect of this medication?

Increased pulse and blood pressure

A nurse is providing medication instruction to a client who has been prescribed simvastatin (Zocor). The nurse explains the action of the medication to the client based on the fact that simvastatin:

Inhibits hepatic synthesis of cholesterol

The parent of a client taking atomoxetine (Strattera) asks how the medication works to control attention deficit hyperactivity disorder (ADHD). The nurse's correct explanation is based on the fact that the medication:

Inhibits norepinephrine (NE) transport and reuptake

A client is being discharged with a prescription for propranolol (Inderal). When providing instructions to the client about the medication, the nurse would include which of the following?

Medication should be withheld if the pulse rate drops below 60 beats per minute.

A nurse provides instructions to the client prescribed to take cyclosporine (Sandimmune) oral solution. Which of the following instructions would the nurse provide?

Mix the concentration with chocolate milk.

A nurse is assisting in preparing a plan of care for a client who will be receiving ritodrine hydrochloride to prevent premature delivery. Which of the following does the nurse include in the plan of care for the client?

Monitor for fluid volume excess.

A client with lung cancer is receiving a high dose of methotrexate (Rheumatrex). Leucovorin (citrovorum factor, folic acid) is also prescribed. The nurse who is assisting in planning care for the client understands that the purpose of administering the leucovorin is to:

Preserve normal cells.

A client is being treated for moderate hypertension and has been taking diltiazem (Cardizem) for several months. The client is seen by the health care provider, and Prinzmetal's angina is diagnosed. The nurse planning care for the client understands that which action of the medication will provide a therapeutic effect for this new diagnosis?

Prevents influx of calcium ions in vascular smooth muscle

Potassium iodide (Lugol solution) is prescribed for a client. The client calls the nurse in the health care provider's office and reports symptoms of a brassy taste in the mouth when taking the medication. Which of following instructions does the nurse provide to the client?

The health care provider will need to be notified for further medication instructions.

A client with suspected opioid overdose has received a dose of nalmefene. The client subsequently becomes restless, starts to vomit, and complains of abdominal cramping. The blood pressure increases from 110/72 to 160/86 mm Hg. The nurse provides emotional support and reassurance while administering care to the client, knowing that:

These are signs of opioid withdrawal.

A client with cancer is receiving cisplatin. Which finding indicates that the client is experiencing an adverse effect of the medication?

Tinnitus

A nurse provides instructions to a pregnant client regarding the administration of iron. The nurse determines that the teaching is effective if the client states that she will take the iron with which of the following food items?

Tomato Juice

Bethanechol chloride (Urecholine) is prescribed for a client. The nurse tells the client to take the medication:

Two hours after meals

A nurse is reviewing the laboratory studies of a client receiving epoetin alfa (Epogen). The nurse expects to note a therapeutic effect of this medication:

Two months after therapy

A urinary analgesic is prescribed for a client with a urinary tract infection. The nurse tells the client that it is best to take the medication:

With meals

A nurse is assisting in caring for a client who is receiving morphine sulfate by continuous intravenous infusion. The nurse ensures that which medication is readily available if a morphine overdose occurs?

Nalmefene (Revex)

A client with cancer is receiving daunorubicin (Cerubidine) intravenously. The nurse assigned to assist in caring for the client monitors for which commonly expected side effect?

Nausea and vomiting

Clients who are given a prescription for sildenafil (Viagra) should be taught that a potentially fatal medication interaction can occur with which medication?

Nitroglycerin (Nitrostat)

A nurse is attending an in-service education session on the therapeutic use of calcium-channel blockers. The instructor of the session determines that teaching has been effective when the nurse correctly identifies that these medications are used for which disorder(s)? Select all that apply. 1. Angina 2. Glaucoma 3. Hypertension 4. Dysrhythmias 5. Acute renal failure 6. Glomerulonephritis

1. Angina 3. Hypertension 4. Dysrhythmias

A client taking phenytoin (Dilantin) has a serum phenytoin level of 30 mcg/mL. The nurse would expect to note which signs and symptoms on data collection of the client? Select all that apply. 1. Ataxia 2. Nausea 3. Tinnitus 4. Diplopia 5. Nystagmus 6. Hyperactive reflexes

1. Ataxia 2. Nausea 4. Diplopia 5. Nystagmus

A client who is receiving infliximab (Remicade) via intravenous (IV) injection is complaining of difficulty swallowing. What is the best initial nursing action?

Notify the registered nurse (RN).

A client taking phenytoin (Dilantin) has a serum phenytoin level of 30 mcg/mL. The nurse would expect to note which of the following signs and symptoms on data collection? Select all that apply. 1. Ataxia 2. Nausea 3. Tinnitus 4. Restlessness 5. Hyperactive reflexes 6. Respiratory rate of 9 breaths per minute

1. Ataxia 2. Nausea 4. Restlessness 6. Respiratory rate of 9 breaths per minute

The nurse would anticipate the use of which medications in the treatment of the client with heart failure? Select all that apply. 1. Diuretics 2. Anticoagulants 3. Anticholinergics 4. Cardiac glycosides 5. Phosphodiesterase (PDE) inhibitors 6. Angiotensin-converting enzyme (ACE) inhibitors

1. Diuretics 4. Cardiac glycosides 5. Phosphodiesterase (PDE) inhibitors 6. Angiotensin-converting enzyme (ACE) inhibitors

A client taking an aldosterone antagonist known as eplerenone (Inspra) for hypertension asks about side effects of this medication. The nurse tells the client that which of the following is a side effect?

Hyperkalemia

A client is experiencing impotence after taking an antihypertensive medication. The client states, "I would sooner have a stroke than keep living with the side effects of this medication." The nurse makes which appropriate response to the client?

"You are concerned about the side effects of your medication."

A nurse is caring for a client who has just had rotator cuff repair. The client asks the nurse how soon he can resume his tai chi classes. The nurse makes which statement to the client?

"You shouldn't be doing any exercises that require the use of your upper arms until you have been cleared to do so by the health care provider."

Which instruction should the nurse provide to the client with diabetes mellitus receiving acarbose (Precose)? Select all that apply. 1. "Take the medication at bedtime." 2. "Take the medication with each meal." 3. "Take the medication on an empty stomach." 4. "Side effects include abdominal bloating and flatus." 5. "Take some form of glucose if hypoglycemia occurs." 6. Report symptoms such as shortness of breath or tiredness."

2. "Take the medication with each meal." 4. "Side effects include abdominal bloating and flatus." 5. "Take some form of glucose if hypoglycemia occurs." 6. Report symptoms such as shortness of breath or tiredness."

The nurse is providing discharge teaching to the client who was given a prescription for nifedipine (Adalat) for blood pressure management. Which instructions should the nurse include? Select all that apply. 1. "Increase water intake." 2. "Increase calcium intake." 3. "Take pulse rate each day." 4. "Weigh at the same time each day." 5. "Palpitations may occur early in therapy." 6. "Be careful when rising from sitting to standing."

3. "Take pulse rate each day." 4. "Weigh at the same time each day." 5. "Palpitations may occur early in therapy." 6. "Be careful when rising from sitting to standing."

A client has been prescribed acarbose (Precose) for treatment of diabetes mellitus. Client teaching regarding this medication should include which of the following? Select all that apply. 1. Fatty stools are common. 2. Dizziness should be expected. 3. Abdominal cramping is common. 4. Side effects include excessive flatulence. 5. The medication should be taken with each meal. 6. The medication should be taken with a full glass of water only.

3. Abdominal cramping is common. 4. Side effects include excessive flatulence. 5. The medication should be taken with each meal.

A client with a closed head injury is receiving phenytoin (Dilantin), an anticonvulsant medication. Which of the following would indicate that the client is experiencing side effects related to this medication? Select all that apply. 1. Ataxia 2. Sedation 3. Constipation 4. Bleeding gums 5. Hyperglycemia 6. Decreased platelet count

3. Constipation 4. Bleeding gums 5. Hyperglycemia 6. Decreased platelet count

Nalidixic acid (NegGram) is prescribed for the client with a urinary tract infection. Reviewing the client's record, the nurse notes that the client is taking warfarin (Coumadin) on a daily basis. Which of the following prescriptions would the nurse anticipate because the client is taking this oral anticoagulant?

A reduction in the anticoagulation dosage

Methenamine is prescribed for a client with a gram-positive urinary tract infection. The nurse questions the prescription if which of the following preexisting disorders is noted in the client's record?

Cirrhosis

A nurse is providing dietary instructions to a client who is taking spironolactone (Aldactone). The nurse instructs the client to avoid which of the following in the daily diet?

Citrus fruits

A nurse is collecting data from a client receiving pioglitazone (Actos) 30 mg orally daily. Which finding indicates that the client is experiencing the expected result of the action of this medication?

Decreased fasting blood glucose and reduced hemoglobin A1C (HbA1c)

A nurse is assisting in monitoring a preterm infant in the neonatal intensive care unit who received surfactant (Infasurf). The nurse monitors for which desired therapeutic outcome of this medication?

Decreased tachypnea and nasal flaring

Regular insulin is prescribed for a child with type 1 diabetes mellitus. The nurse is planning a teaching session with the child and mother about the onset, peak, and duration times of the insulin. The nurse provides which information about this type of insulin?

Onset of 30 minutes from injection time, peak of 2 to 4 hours later, and duration time of 4 to 8 hours

The nurse notes that meloxicam (Mobic) is prescribed for a client. The nurse anticipates the client to have a diagnosis of:

Osteoarthritis

Warfarin sodium (Coumadin) is prescribed for a client. The nurse expects that the health care provider will prescribe which of the following to monitor for a therapeutic effect of the medication?

Prothrombin time (PT)

The hospitalized client with angina continues to have chest pain after the initial administration of a sublingual nitroglycerin tablet. The nurse's priority action is to:

Provide a second sublingual dose in 5 minutes.

A nurse in the emergency department is preparing to instill fluorescein into the eye of a client with the complaint of eye pain. The nurse understands the rationale for the use of this medication is to:

Provide visualization of injury to the cornea.

A nurse working in a pediatric clinic is preparing to administer childhood vaccinations to a 15-month-old child. Which vaccine should be added to the child's routine immunizations at this time because the child is older than 12 months of age?

Varicella

A nurse is teaching a client with essential hypertension about medication therapy with irbesartan (Avapro). Which client statement would indicate a need for further teaching?

"The medication reduces my need for exercise."

Thyroid replacement therapy is prescribed for a client diagnosed with hypothyroidism. The client asks the nurse when the medication will no longer be needed. Which response by the nurse would be accurate?

"The medication will need to be continued for life."

A nurse is admitting a client to the hospital who has been scheduled for gastrointestinal (GI) surgery. When asking the client whether the client takes over-the-counter medications, the nurse becomes concerned when the client states:

"Yes, I take full-strength aspirin every day."

Somatrem (Protropin) is administered to a client with pituitary dwarfism. The expected therapeutic effect of this medication is to:

Stimulate linear growth.

A nurse is assisting to administer acetylcysteine (Mucomyst) to a client admitted with acetaminophen (Tylenol) overdose. Before giving this medication, the nurse would ensure that the:

Stomach is empty from emesis or lavage.

Tacrolimus (Prograf) is prescribed for a client. Which of the following disorders, if noted on the client's record, indicates that the medication needs to be administered with caution?

Renal insufficiency

A nurse is assisting in caring for a client who is receiving a dose of nalmefene intravenously to treat opioid overdose. The nurse plans to have which of the following available as supportive equipment in case it is needed?

Resuscitation equipment

A nurse is helping prepare instructions for a client who has developed stomatitis following the administration of a course of antineoplastic medications. Which of the following instructions does the nurse suggest to include in the plan of care?

Rinse the mouth with diluted baking soda or saline.

A nurse is caring for a client with a diagnosis of chronic renal failure who is receiving dialysis. Epoetin alfa (Epogen) has been prescribed for the client. The nurse prepares to administer the medication by:

The subcutaneous route

A nursing student prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client, and the registered nurse asks the nursing student how the medication works. The student correctly responds that the medication works in the gastrointestinal tract by releasing:

Sodium ions in exchange for primarily potassium ions

A health care provider tells the nurse that a potassium-sparing diuretic is being prescribed for the client with congestive heart failure. The nurse reviews the health care provider's prescriptions, expecting that which of the following medications will be prescribed?

Spironolactone (Aldactone)

A 16-year-old child is brought to the emergency department by his mother with a complaint that the child just experienced a tonic-clonic seizure. On arrival in the emergency department no apparent seizures were occurring. The mother states that her son is taking medication for the seizure disorder. The nurse plans care, knowing that which of the following medications are used for long-term control of tonic-clonic seizures? Select all that apply. 1. Diazepam (Valium) 2. Alprazolam (Xanax) 3. Gabapentin (Neurontin) 4. Ethosuximide (Zarontin) 5. Carbamazepine (Tegretol) 6. Methylphenidate (Ritalin)

3. Gabapentin (Neurontin) 4. Ethosuximide (Zarontin) 5. Carbamazepine (Tegretol)

A nurse is admitting a client to the hospital for the treatment of dehydration. The client reports nausea, vomiting, diarrhea, and cramping for the past week. The nurse asks the client about medications he is taking. The client denies taking prescription medications but states he has been taking some herbs given to him by his cousin. The nurse alerts the health care provider when the client states he has been taking:

Senna

The nurse caring for the older adult client understands that dosages of many medications are reduced in this population because:

Serum albumin levels are decreased.

A nurse is performing an assessment on a pregnant client who has had a severe asthma attack. The nurse asks the client about prescription and herbal medications she is taking and the client tells the nurse that she has been taking the herb chamomile. The nurse refers to an herbal reference book and discovers that chamomile:

Should not be used by pregnant women and persons with asthma

A nurse is comparing the use of nalbuphine (Nubain) versus meperidine (Demerol) for pain management for a pregnant client. Which statement is true with regard to the use of nalbuphine or meperidine?

Nalbuphine is less likely to cause significant respiratory depression.

A nursing student demonstrates understanding of the pathophysiology of reflex tachycardia in the client taking an antihypertensive medication by stating which of the following?

"When blood pressure begins to decrease, the heart responds with tachycardia as a compensatory mechanism to raise the blood pressure."

A nurse is discharging a client from the hospital who was given a prescription for atorvastatin (Lipitor). The nurse tells the client to report which adverse effect to the health care provider immediately?

Muscle pain and weakness

The health care provider prescribes ibuprofen (children's Motrin) 5 mg per kg for a child who weighs 13 pounds. How many mg would the nurse administer to the child? Round answer to the nearest tenth.

29.5

A nurse is caring for a client with liver disease. Laboratory studies are performed, and the client's serum calcium level is 13 mg/dL. The nurse checks to see that which medication is available in the stock medication supply area on the clinical nursing unit that may be needed to treat this calcium imbalance?

Calcitonin (Cibacalcin)

The nurse is caring for a female client receiving chemotherapy and notes that the client has developed myelosuppression. Which of the following laboratory values would support the client's diagnosis of myelosuppression?

Hemoglobin 9.4 g/dL, hematocrit 26%

A client is being given a transcutaneous electrical nerve stimulation (TENS) unit to use for relief of chronic pain. Choose the instructions that the nurse provides to the client about the TENS unit. Select all that apply. 1. Using this unit will help relieve the pain. 2. Hospitalization is required for this treatment. 3. The unit needs to be prescribed by the health care provider. 4. The unit works after attaching electrodes to the skin. 5. The unit will decrease the amount of pain medication needed. 6. The electrode attached to the unit are placed on the skin around the area of pain.

1. Using this unit will help relieve the pain. 3. The unit needs to be prescribed by the health care provider. 4. The unit works after attaching electrodes to the skin. 5. The unit will decrease the amount of pain medication needed. 6. The electrode attached to the unit are placed on the skin around the area of pain.