NLN Practice Pharm Exam
How many grams are equivalent to 30 mg? • 0.03 • 0.3 • 3 • 300
a. 0.03
A client who is receiving bethanechol chloride (Urecholine) develops a cholinergic crisis. Which of these medications should the nurse have available? • Atropine sulfate (Isopto Atropine) • Epinephrine hydrochloride (Adrenalin chloride) • Diphenhydramine hydrochloride (Benadryl) • Acetaminophen (Tylenol)
a. Atropine sulfate (Isopto Atropine)
A nurse should monitor a client who has hypertension and is receiving a beta-adrenergic blocker for which of these adverse effects? • Congestive heart failure • Hypothyroidism • Phlebitis • Hypertension
a. Congestive heart failure
A nurse is assessing a client who is taking glyburide (DiaBeta). Which of these client manifestations who indicate the need for FURTHER assessment prior to administering the scheduled dose of the medication? • Cool, wet skin • Elevated blood pressure • Frequent urination • Blurred vision
a. Cool, wet skin
A nurse should monitor a client who is receiving cefotaxime sodium (Claforan) for side effects, which include • Diarrhea • Vertigo • Tinnitus • Insomnia
a. Diarrhea
A client is scheduled to start antibiotic therapy. Prior to administration of the initial dose; a nurse should • Ensure culture and sensitivity specimens have been obtained • Obtain the client's body temperature • Measure the client's urine output • Determine the client's weight
a. Ensure culture and sensitivity specimens have been obtained
A nurse teaches a client who is taking nadolol (Corgard) for angina about the medication's action and side effects. The nurse should evaluate that the teaching is effective if the client states that which of these manifestations is a side effect of therapy? • Hypotension • Migraine headache • Tremors • Urinary retention
a. Hypotension
Which of these statements, if made by a client who is receiving warfarin sodium (Coumadin), should indicate to a nurse that the client has a correct understanding of the medication instructions? • I will shave with an electric razor. • I will increase my intake of green vegetables. • I will use unwaxed dental floss twice daily. • I will decrease my daily dose if I feel fatigued.
a. I will shave with an electric razor.
A nurse should administer prescribed fluoxetine hydrochloride (Prozac) • In the morning • On an as needed basis • At bedtime • On an empty stomach
a. In the morning
A client is started on vancomycin hydrochloride (Vancocin) for a methylcillin-resistant staphylococcus aureus infection. A nurse should monitor the client carefully for signs of renal toxicity, which include • Increased serum creatinine level • Decreased blood urea nitrogen (BUN) level • Increased blood pressure • Intermittent flank pain
a. Increased serum creatinine level
A nurse is teaching a client who has osteoarthritis about naproxen (Naprosyn). The nurse should include which of these instructions? • Maximum effectiveness may take two to four weeks of continued therapy • The medication may be taken with aspirin to improve pain relief. • You will need to carefully monitor your blood sugar levels • It is important that you avoid sun exposure
a. Maximum effectiveness may take two to four weeks of continued therapy
A client who has an elevated serum cholesterol level is started on pravastatin (Pravachol). A nurse should teach the client to monitor for side effects, which include • Myalgia • Hypertension • Tremors • Tachycardia
a. Myalgia
A nurse should assess a client who is receiving nifedipine (Adalat) for the development of side effects, which include • Peripheral edema • Hypertension • Tinnitus • Sexual dysfunction
a. Peripheral edema
A nurse should assess a client who is taking isoniazid (INH) for side effects, which include • Peripheral neuropathy • Hypertension • Weight gain • Elevated blood glucose levels
a. Peripheral neuropathy
A client is receiving nalbuphine hydrochloride (Nubain). Before administering the medication, it is most important for a nurse to assess the client's • Respiratory status • Pupillary reaction • Pulse rate • Blood sugar
a. Respiratory status
A nurse should teach a client who is receiving methylprednisolone sodium succinate (Solu-Medrol) to report adverse effects which include • Sort throat • Fatigue • Diarrhea • Weight loss
a. Sort throat
A nurse should instruct a client who has been taking fentanyl (Duragesic) for several weeks to • Taper this medication slowly when discontinuing its use • Increase the dosage when pain persists for several hours • Limit physical activity while on this medication • Vigorously rub medication into skin
a. Taper this medication slowly when discontinuing its use
A client is receiving an IV infusion of 20 units of a medication mixed in 1 L of 0.9%NaCl. How many units of the medication are present in one milliliter of solution? • 0.002 • 0.02 • 0.2 • 2
b. 0.02
A vial contains 5 grams of an antibiotic in 20 mL of solution. If a client is to receive 250 mg, how many mL should a nurse give to the client? • 0.5 • 1 • 1.5 • 2
b. 1
A client is to receive 200mg of a medication. The medication is available as a 0.5gm/5mL suspension. How many mL should a nurse administer to the client? a. 0.5 b. 2 c. 2.5 d. 4
b. 2
A client is receiving an IV solution of 20,000 units of heparin sodium in 1 L of D5Wat a rate of 125 mL/hr. How many units per hour is the client receiving? • 1,000 • 2,500 • 3,125 • 3,750
b. 2,500
The total daily dosage of a medication for a client is 4,000mg to be administered in two equal doses. The medication is available in 0.5 gm tablets. How many tablets should be given for each dose? • 2 • 4 • 6 • 8
b. 4
A physician orders 40 mg of a medication IVPB to be diluted in 100 mL of D5W and administered over 2 hours. If the tubing delivers 60 drops/mL, a nurse should regulate the infusion to run at how many drops/minute? • 20 • 50 • 100 • 120
b. 50
A nurse should question an order for meperidine hydrochloride (Demerol) for a client who is receiving which of these medications? • An anti-anxiety medication • A monoamine oxidase (MAO) inhibitor • An antihypertensive medication • A diuretic
b. A monoamine oxidase (MAO) inhibitor
A nurse is preparing to administer buspirone (BuSpar) to a client. The nurse should recognize that the medication is classified as a • Antidepressant • Anti-anxiety agent • Antiseizure medication • Antipsychotic
b. Anti-anxiety agent
Which of these parameters should a nurse monitor in a client who is taking furosemide (Lasix)? • Respiratory rate • Blood pressure • Pulse oximetry • Babinski reflex
b. Blood pressure
Which of these changes should a nurse expect to observe if a client has a therapeutic effect to amlodipine (Norvasc)? • Greater flexibility • Decreased blood pressure • Improved cognition • Decreased pain
b. Decreased blood pressure
Prior to the administration of each dose of metroprolol tartate (Lopressor), a nurse should measure a client's • Urine output • Heart rate • Capillary refill • Body weight
b. Heart rate
Which of these statements, if made by a client who is receiving vancomycin (Vancocin) should prompt a nurse to assess the client prior to administering the next dose? • I have a headache • I can't hear the television • I have not had a bowel movement in 2 days • I feel drowsy
b. I can't hear the television
A nurse should monitor a client, who is taking an angiotensin converting enzyme (ACE) inhibitor, for evidence of therapeutic effects, which include • Increased cardiac workload • Increased exercise tolerance • Increased peripheral vascular resistance • Increased respiratory effort
b. Increased exercise tolerance
A nurse should administer eye drops • Directly onto a client's eye • Into a clients lower conjunctival sac • Underneath a client's pupil • Onto the inside corner of a client's eye
b. Into a clients lower conjunctival sac
A nurse should administer a client's prescribed theophylline (Slo-Bid) • On a pm basis • On an empty stomach • With antiacids • Every 4 hours
b. On an empty stomach
An elderly client is to start on cephradine (Velosef) for a wound infection. Before beginning this medication, it would be important for a nurse to question the client about a history of • Hypertension • Penicillin allergy • Drug dependence • Depression
b. Penicillin allergy
A nurse should inform a client, who is taking phenytoin sodium (Dilantin), of the need for • Annual vision screening • Regular dental check-ups • Monthly hearing tests • Weekly weight monitoring
b. Regular dental check-ups
A nurse on the postpartum unit is preparing to administer Rh-immune globulin (RhoGAM). The nurse should recognize that this medication is indicated for which of these clients? • Rh-neg mother who has an Rh-neg infant • Rh-neg mother who has an Rh-pos infant • Rh-pos mother who has an Rh-pos infant • Rh-pos mother who has an Rh-neg infant
b. Rh-neg mother who has an Rh-pos infant
A client has an order for 200 mg of cimetidine hydrochloride (Tagamet) IM. It is supplied in a vial that contains 300 mg/2 mL. How many milliters should a nurse administer to the client? (single answer) • 0.6 • 0.75 • 1.3 • 1.5
c. 1.3
A child who weighs 40 lb (18kg) is to receive a 900 mg of an antibiotic IV q6h. The antibiotic is available in 1.5g/vial and it is to be reconstituted to a concentration of 375 mg/mL. How many mL per does should the child receive? • 0.6 • 1.6 • 2.4 • 6.9
c. 2.4
A physician orders heparin sodium (Liquaemin Sodium) 1,250 units/hour IV for a client. The IV solution contains 25,000 unites of heparin in 500mL. A nurse should set the infusion pump to run at how many mL/hr? • 20 • 22 • 25 • 30
c. 25
A physician orders intravenous fluids 1,000 mL of D5NS to be administered to a client over eight hours. If the intravenous is infusing correctly, how many milliliters should be left in the solution bag after six hours? • 150 • 200 • 250 • 300
c. 250
A client is to receive an intravenous infusion of 1L of Ringer's lactate. If the IV infusion pump is set to deliver 80 mL/hr, he infusion will be completed in 12 hours and • 5 minutes • 20 minutes • 30 minutes • 40 minutes
c. 30 minutes
A nurse should teach a client, who is taking isophane insulin suspension (NPH, Humulin N), to monitor for signs of hypoglycemia how many hours after administration? • 1 to 1 ½ • 2 to 3 • 4 to 12 • 16 to 18
c. 4 to 12
A 35-year-old client is admitted to the hospital for acute hypertension. The client reports stopping all medication several months ago because they interfered with sexual function. A nurse should inform the client that • Serious hypertension is likely to result from stopping medications abruptly • The side effects would have eventually disappeared with continued administration • Alternative medication therapy that will not affect sexual function is available • Stopping the medications now will cause a stroke
c. Alternative medication therapy that will not affect sexual function is available
A nurse should recognize that enoxaparin (Lovenox) is CONTRAINDICATED in a client who has a history of • Congestive health failure • Kidney stones • Bleeding disorder • Asthma
c. Bleeding disorder
Which of these parameters should a nurse plan to monitor for a client who is receiving spironolactone (Aldactone)? • Heart rate • Urine (acetone) level • Body weight • Pulse oximetry
c. Body weight
A client with cytomegalovirus (CMV) is to start on ganciclovir (Cytovene) for retinitis. A nurse should carefully monitor the client for side effects, which include • Tinnitus • Inflammation of the gallbladder • Bone marrow depression • Myalgia and muscle weakness
c. Bone marrow depression
A nurse should expect to observe which of these changes in a client's laboratory results, if the client experience a therapeutic response to a prescribed antihyperlipidemic medication? • Decreased high density lipoprotein (HDL) cholesterol • Increased triglyceride level • Decreased low density lipoprotein (LDL) cholesterol • Increased bilirubin level
c. Decreased low density lipoprotein (LDL) cholesterol
Which of these methods should a nurse use when performing a purified protein derivative (PPD) test for TB? • Point the bevel of the needle downward • Massage the area after the injection • Ensure the wheel forms • Use a 22 gauge, one-inch needle
c. Ensure the wheel forms
Which of these instructions should a nurse include for a client who will take clarithromycin (Biaxin) at home? • Avoid citrus juice • Stop this medication if you develop nausea • Finishing taking all of these pills • You may experience dizziness when changing positions
c. Finishing taking all of these pills
A nurse should recognize that which of these client reports is a side effect related to a prescribed nitrate medication? • Joint pains • Double vision • Headache • Sweating
c. Headache
A nurse should instruct the client, who is taking isophane insulin suspension (NPH, Humulin N), to eat a snack at which of these time? • One-half hour prior to he dose • Immediately after the dose • In the mid-afternoon • Every two hours during the daytime
c. In the mid-afternoon
A client who has renal failure is receiving sodium polystyrene sulfonate (Kayexalate). A nurse should recognize the purpose of this medication is to • Increase the serum sodium level • Decrease phosphorous absorption • Reduce serum potassium • Prevent loss of calcium
c. Reduce serum potassium
A nurse should plan to monitor which of these laboratory tests for a client who is receiving digoxin (Lanoxin)? • Blood urea nitrogen (BUN) • Serum glucose • Serum potassium • Complete blood count
c. Serum potassium
When preparing to give a 5-year-old an intramuscular injection, a nurse should take which of these actions? • Tell the child to hold still so the injection would not hurt • Show the child the amount of medication in the syringe • Tell the child about the injection immediately before giving it to the child • Allow the child to observe another child receiving an injection
c. Tell the child about the injection immediately before giving it to the child
A nurse should question an anti-hyperlipidemic medication for which of these client? • a 30-year-old client who has a history of heart disease • a 44-year-old client who has recurrent urinary tract infections • a 57-yaer-old client who has cirrhosis related to alcohol abuse • a 79-year-old client who has bilateral cataracts
c. a 57-yaer-old client who has cirrhosis related to alcohol abuse
A client is to receive 1 mg of a medication. If the medication is available in a solution of 5mg/9mL, how many mL of the medication should the client receive? • 0.2 • 0.6 • 1.4 • 1.8
d. 1.8
An 18-month-old child who weights 37 lb (17kg) has a temperature of 103 F (39.4 C). A physician orders acetaminophen (Tylenol) 15 mg/kg. How many milligrams should a nurse administer? • 120 • 148 • 200 • 255
d. 255
A client is to receive an IV infusion of 1 L of D5NS. IF the IV infusion pump is set to deliver 60 mL/hr, the infusion will be completed in 16 hours and • 5 min • 10 min • 20 min • 40 min
d. 40 min
A client is to receive 50 mL of intravenous solution in 45 minutes. A nurse should regulate the client's infusion pump to deliver approximately how many milliliters each hour? • 37 • 45 • 52 • 67
d. 67
A client is to receive 5 mcg/kg/min of a medication. If the client weighs 66 lb (30kg), how many mcg should the client receive in 1 hr? • 150 • 360 • 3,300 • 9,000
d. 9,000
A client is to start on nitroglycerin for acute angina attacks. A nurse should teach the client to • Wait five minutes before taking the medication, if experiencing pain • Discontinue the medication if the client experiences a headache • Take a second dose ten minutes after the first does, if no relief is felt after the initial dose • Allow the medication to dissolve under the tongue
d. Allow the medication to dissolve under the tongue
A client who was taking warfarin sodium (Coumadin) at home is admitted to the hospital. The international normalized ratio (INR) on admission is 1.2. Which of these actions should a nurse take first? • Administer phytonadione (AquaMEPHYTON) to the client? • Withhold the client's next dose of warfarin sodium (Coumadin) • Encourage the client to increase intake of iron-rick foods • Determine if the client is taking the medication as prescribed
d. Determine if the client is taking the medication as prescribed
A nurse should observe a client who is taking a calcium channel blocker for side effects, which include • Hypertension • Urinary retention • Weight loss • Diplopia
d. Diplopia
A nurse should include which of these instructions for a client who is receiving sublingual nitroglycerin (Nitrostat) • Do not take this medication if you heart rate is irregular • Chew the tablet well to increase the therapeutic effects • Take a minimum of four tablets for chest pain before going to the emergency department • Discard unused pills if the bottle has been opened for six months
d. Discard unused pills if the bottle has been opened for six months
Acetaminophen (Tylenol) 120 mg PO stat for a fever of 102.6 F (39.2 C) is ordered for an infant who weighs 12lb (5.5 kg). A nurse identifies that the recommended doses for infants is 10 to 15 mg per kg of bod weight. The nurse should take which of these actions? • Give the medication as ordered • Administer 2/3 of the prescribed dose • Give ½ of the dose bid • Discuss the order with the physician
d. Discuss the order with the physician
Which of these client assessments should a nurse make prior to administering terbutaline sodium (Brethine) subcutaneously? • Urine output • Body temperature • Pulse oximetry • Heart rate
d. Heart rate
A client who is receiving chemotherapy is started on epoetin alfa (Epogen). A nurse should recognize that the medication is having the desired effect if the client develops • Decreased lymphocytes • Decreased neutrophils • Increased platelet count • Increased hematocrit level
d. Increased hematocrit level
A client who is receiving chemotherapy has these laboratory results; white blood cell count (WBC): 8,000 mm3, platelets : 45,000 uL, hemoglobin: 14 g/dL, hematocrit: 46%. Which of these actions should a nurse take first? • Treat underlying infections • Encourage increased intake of iron-rich foods • Obtain a type and cross match for packed cells infusion • Institute bleeding precautions
d. Institute bleeding precautions
A nurse should observe a client who is taking captopril (Capoten) for adverse effects, which include • Dehydration • Peripheral edema • Hyperglycemia • Persistent cough
d. Persistent cough
A client who has renal failure has all of these prescriptions. Which on should a nurse question? (single answer) • Ampicillin sodium (omnipien-N) • Calcitriol (Rocaltrol) • Diphenhydramine hydrochloride (Benadryl) • Tobramycin sulfate (Nebcin)
d. Tobramycin sulfate (Nebcin)
Prior to the administration of potassium chloride (K-lor) intravenously, a nurse should measure a client's • Blood pressure • Respiratory rate • Pulse deficit • Urine output
d. Urine output
