Pharmacology Unit 1
87. A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, "We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk." How should the nurse respond to this family's concerns? A) "Vaccinations are not without some risks, but these are far exceeded by the potential benefits." B) "The potential risks of vaccinations have been investigated and determined to be nonexistent." C) "Unfortunately, state laws mandate that your child receive the full schedule of vaccines." D) "Vaccines indeed cause several serious adverse effects, but these are usually treated at the site where your child receives the vaccination."
A) "Vaccinations are not without some risks, but these are far exceeded by the potential benefits."
17. The nurse is aware that it requires approximately how many half-lives for a client to excrete a medication from the body? A) 4-5 B) 10-12 C) 20-25 D) 5-100
A) 4-5
19. A client presents to the emergency department with a drug level of 50 unit/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and not more drug is given. How many minutes will it take for the blood level to reach the non-toxic range? A) 60 B) 30 C) 120 D) 30
A) 60
6. A health care facility is complying with the mandates of The Drug Enforcement Administration (DEA) concerning Schedule II medications when implementing which nursing intervention? Select all that apply. A) Assess to narcotics is controlled by key or codes. B) Narcotics are administered by prescriptions only. C) Only selected narcotics may be automatically renewed. D) The administration of individual narcotic doses are recorded in specific unit documentation. E) Any recognized discrepancy involving a narcotic must be reported to the appropriate facility authority.
A) Assess to narcotics is controlled by key or codes. B) Narcotics are administered by prescriptions only. D) The administration of individual narcotic doses are recorded in specific unit documentation. E) Any recognized discrepancy involving a narcotic must be reported to the appropriate facility authority.
69. A client is taking atorvastatin to reduce serum cholesterol. Which aspect of client teaching is most important? A) Call the health care provider if muscle pain develops. B) It is unacceptable to eat dietary fats. C) Decrease the dose if lethargy occurs. D) Eat two eggs per day to increase protein stores.
A) Call the health care provider if muscle pain develops.
61. A client is admitted with thrombophlebitis and sent home on enoxaparin therapy. Which statement indicates a good understanding of why enoxaparin is being administered? A) Enoxaparin inhibits the formation of additional clots. B) Enoxaparin eliminates certain clotting factors. C) Enoxaparin decreases the viscosity of blood. D) Enoxaparin will dissolve the existing clots.
A) Enoxaparin inhibits the formation of additional clots.
31. Which of the following are steps of the nursing process? Select all that apply. A) Evaluation B) Documentation C) Reporting D) Assessment E) Planning
A) Evaluation D) Assessment E) Planning
30. In response to the client's question about how to know whether drugs are safe, the nurse explains that all medications in the United States undergo rigorous scientific testing controlled by what organization? A) Food and Drug Administration (FDA) B) Drug Enforcement Agency (DEA) C) Centers for Disease Control and Prevention (CDC) D) Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
A) Food and Drug Administration (FDA)
5. Which term is used to describe the study of drugs and their action on living organism? A) Pharmacology B) Microbiology C) Biology D) Pharmacotherapeutics
A) Pharmacology
27. A client has informed the nurse that he has begun supplementing his medication regimen with a series of herbal remedies recommended by his sister-in-law. Which is the most important nursing intervention regarding the safe use of herbal supplements? A) Research for potential interactions with medications. B) Instruct the client to discontinue them if taking prescription medications. C) Instruct the client to take the supplements 1 hour before prescription medications. D) Instruct the client to take the supplements 3 hours after prescription medications.
A) Research for potential interactions with medications.
29. A client has been prescribed a selective serotonin reuptake inhibitor (SSRI) to treat depression. The regular use of which herbal supplement requires intervention by the nurse? A) St. John's wort B) glucosamine C) chondroitin D) melatonin
A) St. John's wort
24. The nurse is preparing to start an IV on a client who requires antibiotic therapy. The client is prescribed an intravenous antibiotic. What is the major advantage of the intravenous route over the enteral route? A) The associated infection will be resolved faster. B) The client will not need close monitoring for adverse effects. C) The client is at risk of developing a future tolerance to the antibiotic. D) Resolution of the infection will require a larger dose of antibiotic.
A) The associated infection will be resolved faster.
3. While studying for the test, a nursing student encounters the following drug: ibuprofen (Motrin). What does the nursing student identify the name ibuprofen as? A) The generic name B) The chemical name C) The brand name D) The chemical and generic name
A) The generic name
93. A client with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents? A) The use of three agents decreases the development of cell resistance. B) The use of three agents increases adherence to treatment. C) The use of three agents increases the serum levels of one of the agents. D) The use of three agents decreases the total adverse effects.
A) The use of three agents decreases the development of cell resistance.
13. Which process occurs between the time the drug enters the body and the time that it enters the bloodstream? A) absorption B) distribution C) metabolism D) excretion
A) absorption
84. A client receives an immunization. The nurse interprets this as providing the client with which type of immunity? A) artificial acquired active immunity B) natural acquired active immunity C) passive immunity D) active immunity
A) artificial acquired active immunity
40. A nurse at a long-term care facility is surprised to learn that a new resident's medication administration record runs four pages in length. The nurse knows that polypharmacy carries risks and will include which interventions into the resident's plan of care? Select all that apply. A) assessment focused on possible drug complications B) evaluation of swallowing ability C) assessment of cognition and mood D) evaluation of medication adherence E) planning for effective cost containment
A) assessment focused on possible drug complications C) assessment of cognition and mood
74. A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication: A) at bedtime B) in the early morning. C) in the evening. D) in the afternoon.
A) at bedtime
2. Which classification applies to Morphine? A) central nervous system depressant B) central nervous system stimulant C) anti-inflammatory D) antihypertensive
A) central nervous system depressant
26. Which assessment should be made by the nurse before administering a new medication? A) determining the client's past medication history B) evaluating the client's health beliefs C) instructing the client on the effect of the medication D) teaching the client about the desired outcomes of drug therapy
A) determining the client's past medication history
53. A 41-year-old male client with a complex medical history has been referred to the endocrinology department. Diagnostic testing and assessment have resulted in a diagnosis of secondary hypogonadism. Which health problem is the most likely etiology of his diagnosis? A) diabetes B) mumps C) an inflammatory process in the testicles D) testicular trauma
A) diabetes
77. A client has been diagnosed with chronic renal failure. Which agent will assist in raising the client's hemoglobin levels? A) epoetin alfa B) pentoxifylline C) estazolam D) dextromethorphan hydrobromide
A) epoetin alfa
50. A client with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives? A) increased risk of pregnancy B) increased blood pressure C) increased risk of thromboembolism D) increased gastric acid
A) increased risk of pregnancy
70. A client has begun taking cholestyramine. Which are noted as the most common adverse effects? A) nausea, flatulence, and constipation B) increased appetite and blood pressure C) fatigue and mental disorientation D) hiccups, nasal congestion, and dizziness
A) nausea, flatulence, and constipation
8. A nursing student in a pharmacology class should be encouraged to study the medications according to which categorization? Select all that apply. A) prototype B) controlled substance C) drug use D) generic names E) therapeutic classification
A) prototype E) therapeutic classification
11. A hospital nurse is vigilant in ensuring the safe use of medications and consistently applies the rights of medication administration. What are the rights of medication administration? Select all that apply. A) right to refuse prescribed medication B) right route for effective medication therapy C) right to effective medication education D) right evaluation of expected results E) right to low-cost medication therapy
A) right to refuse prescribed medication B) right route for effective medication therapy C) right to effective medication education D) right evaluation of expected results
72. Which single drug class is known to be most effective in reducing the major types of dyslipidemia? A) statins B) bile acid sequestrants C) fibrates D) niacin
A) statins
15. An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect? A) toxicity B) increased absorption C) delayed gastric emptying D) idiosyncratic effects
A) toxicity
54. A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED? A) "How would you describe your overall level of health?" B) "Are you taking any medications for high blood pressure?" C) "How has this problem been affecting your relationship with your wife?" D) "Have you suffered any injuries of any kind in the last several months?"
B) "Are you taking any medications for high blood pressure?"
36. An older adult client has sought care for a dermatological health problem that most often requires treatment with an oral corticosteroid. When considering whether to prescribe steroids to this client, the care provider should prioritize which question? A) "Should this client receive a medication that was likely tested on younger adults?" B) "Do the potential benefits of this medication outweigh the potential harm?" C) "Are there plausible herbal or complementary alternatives to this medication?" D) "Is there a younger adult who can oversee this client's medication regimen?"
B) "Do the potential benefits of this medication outweigh the potential harm?"
41. A pregnant woman asks why she needs to take a folic acid supplement. What is the nurse's best explanation for the administration of folic acid? A) "Folic acid prevents the development of contractions." B) "Folic acid prevents neural tube birth defects." C) "Folic acid builds strong fetal bones." D) "Folic acid will decrease nausea and vomiting."
B) "Folic acid prevents neural tube birth defects."
63. A client is discharged from the hospital with a prescription of warfarin. Which statement indicates successful client teaching? A) "If I miss a dose, I will take two doses." B) "I will avoid herbal remedies." C) "I will eat spinach or broccoli daily." D) "I will discontinue my other medications."
B) "I will avoid herbal remedies."
95. A patient having chemotherapy is losing her hair. She asks the nurse if her hair will come back as it originally was. What is the best response by the nurse? A) "I think you have more to worry about than if you have hair. You can buy a wig." B) "Your hair will grow back, but the new hair may be a different color or texture." C) "Your hair will grow back, but it will be very thin and straight." D) "Your hair may not grow back, but we can refer you to a wig specialist."
B) "Your hair will grow back, but the new hair may be a different color or texture."
9. A client is confused and has stated to the nurse, "I wasn't sure whether I'm supposed to take Tylenol or acetaminophen." To best address the client's concern, the nurse should base the response on what information concerning generic and trade names? A) Prescribers should refer solely to generic names in their recommendations and written prescriptions. B) A generic name is independent of any particular drug manufacturer. C) Generic names change frequently, but trade names are more consistent. D) Prescribers should refer solely to trade names in their recommendations and written prescriptions.
B) A generic name is independent of any particular drug manufacturer.
56. A 17-year-old boy has been admitted to the emergency department after suffering a knee sprain during a football practice. The nurse notes that the client has exceptional muscle mass, and the boy quietly admits that this is mostly attributable to the use of steroids, which he obtains from a teammate. What should the nurse teach the boy about anabolic steroid abuse? A) The ability of anabolic steroids to build muscle is greatly exaggerated in the media. B) Anabolic steroids are universally dangerous but are especially harmful to adolescents. C) The muscle mass resulting from steroid use will atrophy unless doses are continually increased. D) Anabolic steroids will reduce the boy's ability to perform weight-bearing exercise later in life.
B) Anabolic steroids are universally dangerous but are especially harmful to adolescents.
65. A 55-year-old man has been diagnosed with coronary artery disease and begun antiplatelet therapy. The man has asked the nurse why he is not taking a "blood thinner like warfarin." What is the most likely rationale for the clinician's use of an antiplatelet agent rather than an anticoagulant? A) Antiplatelet agents do not require the man to undergo frequent blood work, anticoagulants require constant blood work to ensure safety. B) Antiplatelet agents are more effective against arterial thrombosis ,anticoagulants are more effective against venous thrombosis. C) Antiplatelet agents are most effective in large vessels, anticoagulants are most effective in the small vessels of the peripheral circulation. D) Antiplatelet agents have fewer adverse effects than anticoagulants.
B) Antiplatelet agents are more effective against arterial thrombosis, anticoagulants are more effective against venous thrombosis.
49. A client taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which action should the nurse encourage the client to take to best minimize risk for complications associated with contraception use? A) Beginning an exercise regime. B) Beginning smoking cessation. C) Beginning daily aspirin therapy. D) Beginning taking a loop diuretic to aid weight loss.
B) Beginning smoking cessation.
92. A 49-year-old client is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells? A) Cancerous cells do not require an energy source in order to proliferate. B) Cancerous cells grow in an uncontrollable fashion. C) Cancerous cells have a theoretically infinite life span. D) Cancerous cells are not responsive to the presence of drugs.
B) Cancerous cells grow in an uncontrollable fashion.
71. A client is prescribed fenofibrate. When providing client teaching, which accurately describes the action of fenofibrate? A) It binds to bile acids in the intestinal lumen. B) It increases oxidation of fatty acids in the liver. C) It inhibits an enzyme required for hepatic synthesis. D) It inhibits mobilization of free fatty acids from peripheral tissues.
B) It increases oxidation of fatty acids in the liver.
22. A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels? A) It is necessary to regularly test for blood-drug incompatibilities that may develop during treatment. B) It is necessary to ensure that the client's drug levels are therapeutic but not toxic. C) It is needed to determine if additional medications will be needed to potentiate the effects of lithium. D) It is needed in order to confirm the client's adherence to the drug regimen.
B) It is necessary to ensure that the client's drug levels are therapeutic but not toxic.
81. An infant is being administered an immunization. Which statement provides an accurate description of an immunization? A) It should be administered to a pregnant woman prior to the infant's birth. B) It is the administration of an antigen for an antibody response. C) It produces many adverse reactions, particularly autism, in the infant. D) It protects the infant from exposure to infectious antibodies.
B) It is the administration of an antigen for an antibody response.
73. A male client has been diagnosed with moderately increased LDL, and his primary care provider wishes to begin him on a statin. What is a potential disadvantage of statins that the care provider should consider? Select all that apply. A) Statins are nephrotoxic. B) Statins are expensive. C) Statins are contraindicated in clients with a history of myocardial infarction. D) Statins require regularly scheduled blood work. E) Statins have an immunosuppressive effect.
B) Statins are expensive. D) Statins require regularly scheduled blood work.
35. An infant who recently experienced seizures is being treated in the neonatal intensive care unit with phenytoin. The infant's low plasma protein levels during the first year of life have what consequence? A) The infant may have an unpredictable drug response. B) The infant may have an increased risk of toxicity. C) The infant may experience impaired elimination of the drug. D) The infant will have an increased rate of drug metabolism.
B) The infant may have an increased risk of toxicity.
33. When considering physiological variables that influence safe pharmacotherapy in clients younger than 18, which principle should the nurse integrate into care? A) The physiology of clients older than 15 can be considered to be the same as an adult client. B) The younger the client, the greater the variation in medication action compared to an adult. C) The larger the client's body mass index, the more his or her physiology varies from that of an adult. D) Pediatric clients have a greater potential to benefit from pharmacotherapy than adult clients.
B) The younger the client, the greater the variation in medication action compared to an adult.
16. What is the primary role of protein binding on drug action? A) increasing the medication's speed of action B) decreasing the medication's speed of action C) increasing the rate of the medication's excretion D) averting the risk of adverse effects posed by the medication
B) decreasing the medication's speed of action
34. Significant pharmacodynamic variations exist between adult clients and pediatric clients. Which factor is known to contribute to differences in the ways that drugs affect target cells in children and infants? Select all that apply. A) inability of children to accurately describe adverse effects B) immaturity of children's organ systems C) differences in the body composition of children D) the lack of active immunity in children E) differences in the function of humoral immunity in children
B) immaturity of children's organ systems C) differences in the body composition of children
76. An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy? A) complete blood count (CBC) B) liver panel C) INR and aPTT D) reticulocyte count
B) liver panel
23. A client in medical unit requires pharmacological interventions involving a slow drug action and response. What route of administration is most likely appropriate? A) intravenous B) oral C) rectal D) topical
B) oral
20. Which factor accounts for the increased risk for drug reactions among clients aged 65 years and older? A) drugs more readily crossing the blood-brain barrier in older people B) physiologic changes affecting all pharmacokinetic processes C) increased drug-metabolizing enzymes in older people D) diminished immune response
B) physiologic changes affecting all pharmacokinetic processes
18. Which statement accurately describes the concept of a medication's serum half-life? A) the time required for IV medications to penetrate the brain tissue B) the time needed for the serum level to fall by 50% C) the safest margin to prevent toxicity D) the dose adjustment that reduces the risk of adverse effects by one half
B) the time needed for the serum level to fall by 50%
60. The nurse educates a client diagnosed with atrial fibrillation about the prescribed warfarin. Which client statements establish the need for further clarification? A) "I will keep my lab appointments for prothrombin and INR levels." B) "I will take the warfarin at the same time each day." C) "I will not eat green leafy vegetables, broccoli, yogurt, or cheese." D) "I will not drink alcohol unless it is all right with my primary care provider."
C) "I will not eat green leafy vegetables, broccoli, yogurt, or cheese."
55. The nurse is educating an older adult client newly diagnosed with benign prostatic hypertrophy (BPH) about the prescribed tamsulosin. Which statement made by the client establishes the need for further clarification? A) "I will inform my dentist or eye doc that I take tamsulosin and other drug I am prescribed." B) "I will rise from the bed or chair slowly because the drug may cause hypotension or dizziness." C) "The drug can be taken on an empty stomach to improve absorption and effectiveness of the drug." D) "If I have experience problems with falling or staying asleep, I will notify my prescriber for further help."
C) "The drug can be taken on an empty stomach to improve absorption and effectiveness of the drug."
45. A woman who is at 31 week's gestation comes to the clinic in labor. The health care provider decides to use terbutaline therapy before transferring the woman to the hospital. The client is upset and confused and ask the nurse why can't just have the baby, that it's only 5 weeks early. An appropriate response by the nurse should be: A) "This drug will make you delivery in few days less painful." B) "The drug that you are being given will prevent and control postpartum bleeding." C) "The drug provides sufficient time for other medication to be given to improve your baby's outcome." D) "This drug helps induce uterine contractions and milk ejection for breast-feeding."
C) "The drug provides sufficient time for other medication to be given to improve your baby's outcome."
89. A client is administered mycophenolate to prevent rejection of the transplanted heart. It is recommended that the client have a CBC drawn weekly. The client asks the nurse the reason for the weekly CBC. Which is the nurse's best response? A) "The weekly CBC is routine and ordered for all clients." B) "The weekly CBC assesses for the development of bleeding." C) "The weekly CBC assesses for the development of infection." D) "The weekly CBC assesses for changes in your blood's oxygen-carrying capacity."
C) "The weekly CBC assesses for the development of infection."
12. The nurse is caring for an older adult who needs to know that drugs, even when taken correctly, can produce negative or unexpected effects. The nurse should address what topic during health education? A) Teratogenic effects B) Toxic effects C) Adverse effects D) Paradoxical effects
C) Adverse effects
78. A client with a diagnosis of renal failure is being treated with epoetin alfa. Frequent assessment of which laboratory values should be prioritized before and during treatment? A) AST B) C-reactive protein C) CBC D) ALT
C) CBC
58. A client is admitted to the hospital with deep vein thrombosis. An infusion of heparin is established. What action best protects the client's safety? A) Ensure that the client's call light is easily accessible. B) Have two nurses independently monitor the client's heparin infusion. C) Ensure that protamine sulfate is ready available. D) Keep a preloaded syringe of vitamin K in the room.
C) Ensure that protamine sulfate is ready available.
7. Which organization is responsible for approving new drugs in the United States? A) American Medical Association (AMA) B) American Pharmaceutical Association (APA) C) Food and Drug Administration (FDA) D) United States Pharmacopeia
C) Food and Drug Administration (FDA)
38. Laboratory testing of an older adult client, who is well known to the clinic nurse, indicates that liver function has been gradually decreasing over the last several years. How will this age-related physiological change influence drug metabolism? A) The client will metabolize drugs more quickly but derive less of a therapeutic benefit from them. B) The liver will sequester drug molecules in the hepatocytes, and they will be released at unpredictable times. C) Many of the client's medications will remain in the body for a longer time. D) The client's kidneys will be forced to metabolize a disproportionate quantity of medications.
C) Many of the client's medications will remain in the body for a longer time.
64. A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored? A) RBC B) aPTT C) PT and INR D) platelet count
C) PT and INR
94. A 32-year-old female client is being treated with a cytotoxic antineoplastic agent. Which is the most important instruction related to the potential for teratogenicity? A) The medication will be completely eliminated 24 hours after the administration. B) The client should protect against infections and by taking trimethoprim and sulfamethoxazole. C) The client should not become pregnant for several months. D) The client will not get pregnant due to the elimination of ova.
C) The client should not become pregnant for several months.
21. A client has been prescribed a medication that is known to be a drug agonist. This drug will have what effect? A) It will react with a receptor site on a cell preventing a reaction with another chemical on a different receptor site. B) The drug will interfere with the enzyme system that act as catalyst for different chemical reactions. C) The drug will interact directly with receptor sites to cause the same activity that a natural chemical would case at that site. D) It will react with receptor sites to block normal stimulation, production no effect.
C) The drug will interact directly with receptor sites to cause the same activity that a natural chemical would case at that site.
43. A woman who began labor several hours ago is now prescribed oxytocin. What is the goal of oxytocin therapy? A) prevent postpartum bleeding B) decrease fetal hyperactivity C) augment weak or irregular contractions D) diminish periods of uterine relaxation
C) augment weak or irregular contractions
52. A 34-year-old woman has presented to the clinic for the first time, and the nurse learns that she has been taking medroxyprogesterone for the past 13 years. This aspect of the woman's medical history should prompt what assessment? A) cardiac stress testing B) renal ultrasound C) bone density testing D) evaluation of triglyceride levels
C) bone density testing
82. A client is scheduled to receive an immunization. In which client may the administration of a live vaccine be contraindicated? A) client with renal insufficiency B) client with hepatic failure C) client taking steroid therapy D) client over the age of 65 years
C) client taking steroid therapy
42. A woman is being administered IV magnesium sulfate. What is a desired outcome related to the administration of magnesium sulfate? A) increased contractions B) respiratory rate above 18 C) decreased blood pressure D) increased uterine tone
C) decreased blood pressure
80. A 69-year-old female client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect? A) profound diaphoresis B) decreased level of consciousness C) flu-like symptoms D) cyanosis and pallor
C) flu-like symptoms
46. A nurse is performing health education with a woman who has just learned that she is pregnant. The nurse has explained the concept of teratogenic drugs and emphasized the need to have her care provider assess any medications she should consider taking. The nurse should teach the woman that drug-induced teratogenicity is most likely to occur at what point in her pregnancy? A) during the second half of her third trimester B) in the 7 to 10 days after conception C) in the first trimester during organogenesis D) during 30 to 34 weeks of gestation
C) in the first trimester during organogenesis
51. An insulin-dependent diabetic client has begun taking an oral contraceptive. What effect will this medication regime have on her physiologically? A) increase risk of hypoglycemia B) increase heart rate C) increase blood glucose D) increase risk of metabolic alkalosis
C) increase blood glucose
88. Which is the most likely indication for the use of immunosuppressant agents? A) intractable seizure disorders B) increased intracranial pressure C) organ transplantation D) HIV/AIDS with multiple drug resistance
C) organ transplantation
28. A nurse, preparing to administer a client's scheduled beta-adrenergic blocker, is aware that the client is receiving this medication for the treatment of hypertension. The nurse has addressed which right of safe medication administration? A) right indication B) right diagnosis C) right reason D) right history
C) right reason
1. A nurse is assessing the client's home medication use. After listening to the client list current medications, the nurse asks what priority question? A) "Do you take any generic medications?" B) "Are any of these medications orphan drugs?" C) "Are these medications safe to take during pregnancy?" D) "Do you take any over-the-counter medications?"
D) "Do you take any over-the-counter medications?"
79. A client with a diagnosis of chronic renal failure will soon begin a regimen of epoetin that will be administered by the client at home. Which statement indicates that the nurse's initial health education has been successful? A) "I'll make sure to take my epoetin pill on a strict schedule and make sure I never miss a dose." B) "I'm glad that epoetin can help to protect me from getting an infection." C) "I'm excited that there's a medication that can help my kidneys work better." D) "I'm not all that comfortable with giving myself an injection, but I'm sure I'll be able to learn."
D) "I'm not all that comfortable with giving myself an injection, but I'm sure I'll be able to learn."
4. A nurse is teaching the client about the use of over the counter (OTC) drugs. Which statement best informs the client about their use? A) "OTC drugs are products that are available without prescription for self-treatment of minor health issues." B) "OTC drugs are considered medication and should be reported on a drug history." C) "OTC drugs were approved as prescription drugs but later were found to be safe without the need of a prescription." D) "OTC drugs need to be taken with caution, they can mask the signs and symptoms of an underlying disease and interfere with prescription drug therapy."
D) "OTC drugs need to be taken with caution, they can mask the signs and symptoms of an underlying disease and interfere with prescription drug therapy."
48. During client teaching, a young woman asks the nurse the following question: "If I get pregnant on the 'pill,' should I continue to take it?" What is the nurse's best response? A) "The pill has no effect on pregnancy." B) "The pill will cause miscarriage." C) "This is a personal choice for each woman." D) "The pill can be harmful to the fetus and should be discontinued."
D) "The pill can be harmful to the fetus and should be discontinued."
47. A nurse is instructing a pregnant client concerning the potential risk to her fetus from a Pregnancy Category D drug. What should the nurse inform the client? A) "Adequate studies in pregnant women have demonstrated there is no risk to the fetus." B) "Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women." C) "Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women." D) "There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks."
D) "There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks."
10. A client's current medication administration record includes a drug that the nurse recognizes as an Institute for Safe Medication Practices (ISMP) high-alert medication. This designation signals the nurse to what characteristic of the drug? A) It can only be administered by a health care provider or advanced practice nurse. B) Administration must be cosigned by a second registered nurse or practical/vocational nurse. C) It is currently undergoing Phase 4 testing and is pending full FDA approval. D) Administration errors carry a heightened risk of causing significant client harm.
D) Administration errors carry a heightened risk of causing significant client harm
32. Which nursing action when administering medication to children is appropriately directed toward medication safety? A) If a child is resistant to taking the medication, the nurse should tell the child that it is candy. B) Measurement by teaspoons is as accurate as milliliters. C) If a drug is not supplied in liquid form, the nurse can always crush the pill. D) Assess the child's weight prior to initial drug administration.
D) Assess the child's weight prior to initial drug administration.
85. It is important for the nurse to stay informed of the most current recommendations for immunizations. Which source is most accurate regarding immunization guidelines? A) American Academy of Pediatrics B) American Academy of Family Physicians C) American Academy of Infectious Disease Physicians D) Centers for Disease Control and Prevention
D) Centers for Disease Control and Prevention
91. A client has been discharged from the hospital after a kidney transplant. Which nursing interventions is the first line of defense against the immunosuppressed client developing an infection? A) Ensure visitors do not come to the home. B) Teach the client to wear a mask consistently. C) Administer prophylactic antibiotics. D) Teach the client the importance of personal hygiene.
D) Teach the client the importance of personal hygiene.
67. A 79-year-old woman has been brought to the emergency department by ambulance with signs and symptoms of ischemic stroke. The care team would consider the immediate (STAT) administration of what drug? A) low molecular weight heparin B) vitamin K C) clopidogrel D) alteplase
D) alteplase
57. A client, taking warfarin after open heart surgery, tells the home care nurse she has pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of her medications and the report of pain, what should the nurse suspect is the cause of the pain? A) joint thrombosis B) torn medial meniscus C) degenerative joint disease caused by her medication D) bleeding
D) bleeding
37. When appraising an older adult's ability to excrete medications, what laboratory or diagnostic finding should the nurse prioritize? A) renal ultrasound B) complete blood count (CBC) C) serum bilirubin and albumin levels D) blood urea nitrogen (BUN) and creatinine levels
D) blood urea nitrogen (BUN) and creatinine levels
39. An older adult client has been taking a diuretic and a beta-blocker for the treatment of hypertension for the past several months. During the latest clinic visit, the client states that he or she has been measuring blood pressure regularly at the local drug store and claims that it is usually in the range of 130/80 mm Hg. As a result, the client has cut down on doses of both drugs. The client's actions should indicate the initial need for which intervention? A) assess the client's ability to pay for this long-term medication regimen B) assess the client's cognitive status for signs of confusion that could interfere with medication adherence C) evaluation of the client's ability to accurately monitor blood pressure D) instruction on the need to adhere to the prescribed medication regimen
D) instruction on the need to adhere to the prescribed medication regimen
68. A client with a diagnosis of cardiovascular disease is taking atorvastatin to reduce serum cholesterol. What is the goal of therapy for LDL cholesterol for a client taking atorvastatin calcium? A) 100 to 115 mg/dL B) 75 to 85 mg/dL C) less than 60 mg/dL D) less than 130 mg/dL
D) less than 130 mg/dL
14. Which site is preferred when consideration must be made to identifying an exceptionally large surface area for drug absorption? A) rectum B) fundus of the stomach C) esophagus D) lungs
D) lungs
66. A nurse at a long-term care facility is conducting a medication reconciliation for a man who has just moved into the facility. The man is currently taking clopidogrel. The nurse is most justified suspecting that this man has a history of: A) hemorrhagic cerebrovascular accident. B) hemophilia A. C) idiopathic thrombocytopenic purpura (ITP). D) myocardial infarction.
D) myocardial infarction.
25. A nurse begins a client interaction by systematically gathering information on the client's care and eventually evaluating the outcomes of care. Which represents this continuum of care? A) assessment process B) outcomes analysis C) nursing interventions D) nursing process
D) nursing process
44. A woman in preterm labor has been administered terbutaline sulfate. For what potential adverse effects should the nurse assess the client? A) pruritus (itching) and copious diaphoresis B) joint pain and numbness in her extremities C) headache and visual disturbances D) palpitations and shortness of breath
D) palpitations and shortness of breath
75. A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy? A) reduction in triglycerides B) reduction in total serum cholesterol levels C) increase in HDL levels D) reduction in LDL cholesterol levels
D) reduction in LDL cholesterol levels
83. A client has received a rubella immunization. The client was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this client? A) risk of development of the disease in the newborn B) risk of low infant birth weight C) risk of preterm labor D) risk of birth defects
D) risk of birth defects
62. A client is being discharged from the hospital with warfarin to be taken at home. Which food should the client be instructed to avoid in the diet? A) eggs B) dairy products C) apples D) spinach
D) spinach
90. A client is receiving immunosuppressant therapy and is preparing for discharge. For which should the client be educated? A) the importance of a high-protein diet B) the need to maximize fluid intake C) the need for regular physical activity D) the importance of keeping the home clean
D) the importance of keeping the home clean
59. A client who is receiving warfarin has blood in his urinary catheter drainage bag. What medication will likely be ordered by the health care provider? A) aminocaproic acid B) platelets C) protamine sulfate D) vitamin K
D) vitamin K
86. When providing a health promotion presentation to a group of seniors, how often should the nurse instruct the senior group to obtain influenza vaccines? A) one time only B) every 10 years C) two times per year D) yearly
D) yearly