Pharm practice exam 1

The nurse is preparing to administer an IM inj to a newborn. To admin the inj safely, the nurse would be cognizant of which cause of slow absorption in newborns? a. blood flow b. binding ability c. renal excretion d. hepatic metabolism

a. blood flow

A client who takes rifampin tells the nurse, "My urine looks orange." Which action would the nurse take? a. explain that this is expected b. check the liver enzymes c. ask the provider to order a urinalysis d. ask what foods were eaten

a. explain that this is expected

Which descriptions explain why meds behave differently in toddlers vs adults? SATA a. gastric emptying is slowed in children b. meds are more likely to enter the brains of children c. the gastric pH is more acidic in children d. first-pass elimination by the liver is increased e. glomerular filtration rate is lower in younger clients

a. gastric emptying is slowed in children b. meds are more likely to enter the brains of children e. glomerular filtration rate is lower in younger clients

Which assessment finding during the admin of IV penicillin prompt the nurse to stop the infusion? SATA a. hives b. itching c. nausea d. skin rash e. SOB

a. hives b. itching d. skin rash e. SOB

An infant w/ congenital hypothyroidism receives levothyroxine for 3 months. Which finding would indicate to the nurse that the med is effective? a. the infant is alert and interactive b. the skin is cool to the touch c. the baby's fine tremor has ceased d. the baby's TSH level has increased

a. the infant is alert and interactive

Propylthiouracil and potassium iodide are prescribed for the client w/ hyperthyroidism. Which statement would the nurse include in the client's plan of care? a. administer propylthiouracil and potassium iodide on an empty stomach b. assess the client for signs of infection and bleeding every shift c. stop the meds 2 weeks before thyroid surgery d. discontinue the med if the HR is maintained within the expected range for 48 hours

b. assess the client for signs of infection and bleeding every shift

Which reason would the nurse document as "nonadherence" for the client not adhering to the prescriber antibiotic therapy? a. "skipped some doses b/c I just don't like to take pills" b. "I left my pills in the bedroom and I forgot to take them w/ breakfast" c. "I saw all the side effects on television and decided to not take the pills" d. "I had to choose between getting my prescription filled and paying the heating bill"

b. "I left my pills in the bedroom and i forgot to take them w/ breakfast"

Sulfamethoxazole/trimethoprim is prescribed for a child w/ a UTI. Which statement by the parent indicates the nurse's instructions about admin have been understood? a. "mealtime is a good time to give the med" b. "i'll be sure to give each pill w/ 6-8oz of fluid" c. "it must be taken w/ orange juice to ensure acidity of the urine" d. "the med has to be taken q4hr to maintain a blood level"

b. "i'll make sure to give each pill w/ 6-8oz of fluid"

A PHCP prescribes PTU for a client w/ hyperthyroidism. Two months after being started on the med, the client calls the nurse and complains of feeling tired and looking pale. Which action would the nurse take for this client? a. advise the client to get more rest b. schedule the client for an appointment c. instruct the client to skip one dose daily d. tell the client to increase the med

b. schedule the client for an appointment

A client who recently started receiving oral corticosteroids for a severe allergic reaction is instructed that the dosage will be reduced gradually until all the med is stopped at the end of 2 weeks. Which reason would the nurse provide for this gradual reduction in dosage? a. discontinuing the med too fast will cause the allergic reaction to reappear b. slow reduction of the med will prevent a physiological crisis b/c the adrenal glands are suppressed c. the HCP is attempting to determine the minimal dose that will be effective for the allergy d. sudden cessation of the medication will cause development of serious side effects, such as moon face and fluid retention

b. slow reduction of the medication will prevent a physiological crisis b/c the adrenal glands are suppressed

A client w/ thyroid cancer is scheduled for a thyroidectomy. Which information will the nurse teach the client? a. the dietary intake of carbs must be restricted b. thyroxine replacement therapy will be required indefinitely c. chemotherapy will be used in conjunction w/ the surgery d. a tracheostomy is required for clients having this procedure

b. thyroxine replacement therapy will be required indefinitely

Which issue related to antibiotic use is an increased risk for the older adult? a. allergy b. toxicity c. resistance d. superinfection

b. toxicity

A child infected w/ HIV is admitted w/ Pneumocytsis jiroveci pneumonia and receives sulfamethoxazole/trimethoprim. Which common side effects would the nurse anticipate? SATA a. jaundice b. vomiting c. HA d. crystalluria e. photosensitivity

b. vomiting c. crystalluria e. photosensitivity

Which should the nurse include when teaching a client w/ C. diff about decreasing the risk of transmission to family members? a. increase fluid intake b. a high-fiber diet c. soap and water for hand washing d. wash hands w/ an alcohol-based hand sanitizer

c. soap and water for hand washing

A client receiving IV vancomycin reports ringing in both ears. Which initial action would the nurse take? a. notify the PHCP b. consult an audiologist c. stop the infusion d. document the finding and continue to monitor the client

c. stop the infusion

For which reason would an adolescent client be prescribed an adult dose of acetaminophen? a. the prescription is wt-based b. the dose is adjusted based on outcome c. the prescription can be metabolized at the adult dose d. renal metabolism of acetaminophen is at its peak

c. the prescription can be metabolized at the adult dose

A 28lb toddler is prescribed amoxicillin 145mg PO TID. Med available is supplied as a suspension of 250mg/5mL. The safe dose is 35mg/kg/24hr. How many mg within the safe dosage limit is the dose? record answer w/ one decimal place.

9.5mg

The nurse would include which instruction to the parents of a child being treated w/ oral ampicillin for otitis media? a. complete the entire course of antibiotic therapy b. herbal fever remedies are highly discourages c. administer the med w/ meals d. stop the antibiotic therapy when the child no longer has a fever

a. complete the entire course of antibiotic therapy

A client is taking thyroxine to manage hypothyroidism. Which developments indicate to the nurse that the dosage should be reduced? SATA a. diaphoresis b. wt gain c. tachycardia d. nervousness e. cold intolerance

a. diaphoresis c. tachycardia d. nervousness

The nurse concludes that a client has a hypoglycemic reaction to insulin. Which clinical findings support this conclusion? SATA a. irritability b. glycosuria c. dry, hot skin d. heart palpitations e. fruity odor of breath

a. irritability d. heart palpitations

Which rational accurately explains why insulin is prescribed for clients in acute renal failure? a. it promotes transfer of K into cells to lower serum K levels b. insulin is required b/c the alpha cells of the pancreas cease to function w/ renal failure c. it is necessary to manage the elevated bg levels that accompany renal failure d. insulin reduces the accumulated toxins by lowering the metabolic rate

a. it promotes transfer of K into cells to lower serum K levels

The nurse is caring for a client who is receiving intermittent IV piggyback (IVPG) doses of vancomycin q12hr. The PHCP prescribes trough levels of the antibiotic. The nurse schedules the blood sample to be obtained at which time? a. just before the med is administered b. between 30-60 min after the infusion is completed c. 6hr after the dose is completely infused d. in the morning before the client eats breakfast

a. just before the med is administered

The nurse is teaching an adolescent newly dx w/ T1D about self-care. Which is the primary long-term goal? a. maintaining normoglycemia b. complying w/ the diabetic diet c. adhering to an exercise program d. developing a non-stressful lifestyle

a. maintaining normoglycemia

The nurse is educating the client newly dx w/ T2D on oral antidiabetic meds. Which instruction would the nurse include in the teaching plan? SATA a. the client should obtain a finger-stick bg reading before each meal b. the client does not need to follow a specific diet until insulin is required c. the teaching plan should include s/s of hypoglycemia d. the teaching plan should include how to admin regular insulin e. the teaching plan should include sick day rules

a. the client should obtain a finger-stick bg reading before each meal c. the teaching plan should include s/s of hypoglycemia e. the teaching plan should include sick day rules

Which information from the client's hx would the nurse identify as a risk factor for developing osteoporosis? a. takes estrogen therapy b. receives long-term steroid therapy c. has a hx of hypoparathyroidism d. engages in strenuous physical activity

b. receives long-term steroid therapy

When preparing to safely admin meds to newborns, it is important for the nurse to recognize which factors as contributors to reduced renal med excretion? SATA a. bladder capacity b. renal blood flow c. nephron capacity d. glomerular filtration e. active tubular secretion

b. renal blood flow d. glomerular filtration e. active tubular secretion

The HCP prescribes propylthiouracil for a client w/ the dx of Grave's disease. Which instruction would the nurse teach the client regarding this med? a. "increase sources of Ca" b. "observe for signs of infection" c. "take the med through a straw" d. "wear sunglasses when exposed to sunlight"

c. "observe for signs of infection"

After completing a week of antibiotic therapy, an infant develops oral thrush. Which med is indicated for treatment of this condition? a. acyclovir b. vidarabine c. nystatin d. fluconazole

c. nystatin

A client has T2D controlled w/ oral antidiabetic meds. When admitted for an elective surgery, the HCP prescribes regular insulin. Which information would the nurse include when teaching the client about the addition of insulin? a. "you will need a higher serum glucose level while on bed rest" b. "the stress of surgery may cause hypoglycemia" c. "w/ insulin, dosage can be adjusted to your changing needs during recovery from surgery" d. "the possibility of surgical complications is greater when a client takes oral hypoglycemics"

c. "w/ insulin, dosage can be adjusted to your changing needs during recovery from surgery"

IV vancomycin is scheduled to infuse over 30 min. 10 min after the start of the infusion, the client appears flushed and complains of palpitations. Which action will the nurse take? a. stop the infusion b. continue the infusion but monitor the client c. contact the PHCP to obtain a prescriber to decrease the infusion rate d. contact the PHCP to obtain a prescription for an antianxiety med

c. contact the PHCP to obtain a prescriber to decrease the infusion rate

A client w/ T2D takes on glyburide tab daily. The client asks whether an extra tab should be taken before exercise. Which response will the nurse provide? a. "you will need to decrease how much you are exercising" b. "an extra pill will help your body use glucose when exercising" c. "the amount of med you need to take is not related to exercising" d. "do not take an extra pill b/c you may become hypoglycemic when exercising"

d. "do not take an extra pill b/c you may become hypoglycemia when exercising"

Which statement made by a client recently dx w/ T1D indicates that further education is necessary regarding the teaching plan? a. "i will need to have my eyes and vision examined once a year" b. "i will need to check my bg at home to evaluate my response to my treatment plan" c. "i can improve metabolic and cardiac risk factors of this disease if I follow a healthy diet and exercise routine" d. "once I get my glucose levels under control, there is a good chance that I will be able to switch from insulin to an oral med"

d. "once I get my glucose levels under control, there is a good chance that I will be able to switch from insulin to an oral med"

How would the nurse reply when a client prescribed a tetracycline class med asks why milk and antacids should be avoided before and after dosing? a. "taking these together can lead to kidney impairment" b. "the pairing of these substances leads to tooth staining" c. "severe diarrhea can occur when taking these substances together" d. "this can lead to decreased absorption of the med you need"

d. "this can lead to decreased absorption of themed you need"

A sulfonamide preparation is prescribed for a child w/ a UTI. Which nursing responsibility is a priority when administering this med? a. weighing the child daily b. giving the med w/ milk c. taking the child's temp frequently d. administering the med at the prescribed times

d. administering the med at the prescribed times

Ceftriaxone is prescribed for a client's infection. For which potential adverse effect would the nurse monitor the client? a. dehydration b. HF c. constipation d. allergic reaction

d. allergic reaction

Which complication is an adverse effect of cortisone therapy? a. hypoglycemia b. severe anorexia c. anaphylactic shock d. behavioral changes

d. behavioral changes

A HCP has prescribed isoniazid for a client. Which instruction will the nurse give the client about this med? a. prolonged use can cause dark, concentrated urine b. the med is best absorbed when taken on an empty stomach c. take the med w/ aluminum hydroxide to minimize GI upset d. drinking alcohol daily can cause med induced hepatitis

d. drinking alcohol daily can cause med induced hepatitis

The nurse prepares to admin extended-release metformin to an older adult who has asked that it be crushed b/c it is difficult to swallow. Which rationale will prompt the nurse to ask the HCP for a different form of the metformin? a. this med has a wax matrix frame that is difficult to crush b. the medication has an unpleasant taste, which most clients find intolerable if crushed c. if crushed, this med irritates mucosal tissue and can cause oral and esophageal ulcer formation d. extended-release formulations are designed to be released slowly and crushing the tablet will prevent this from occurring

d. extended-release formulations are designed to be released slowly and crushing the tablet will prevent this from occurring

A client takes an oral hypoglycemic agent daily. For which condition is an oral hypoglycemic agent indicated? a. ketosis b. obesity c. pancreatitis d. reduced insulin production

d. reduced insulin production

Which rationale explains why IV potassium is prescribed in addition to regular insulin for clients in diabetic ketosis? a. K loss occurs rapidly from diaphoresis present during coma b. K is carried w/ glucose to the kidneys to be excreted in the urine in increased amounts c. K is quickly used up during the rapid series of catabolic reactions stimulated by insulin and glucose d. serum K levels will decrease as K ions shift from the extracellular fluid to the intercellular fluid compartment

d. serum K levels will decrease as K ions shift from the extracellular fluid to the intercellular fluid compartment

Which outcome would the nurse expect when caring for a child receiving adreno-corticosteroid therapy? a. accelerated wound healing b. development of hyperkalemia c. increased antibody production d. suppressed inflammatory process

d. suppressed inflammatory process

Which type of med would put a person at risk if they were exposed to the varicella virus? a. anticonvulsant b. antihypertensive c. topical antibiotic d. systemic corticosteroid

d. systemic corticosteroid

A child recovering from a severe asthma attack is given oral prednisone 15mg BID. Which intervention would be a priority for the nurse? a. having the child rest as much as possible b. checking the child's eosinophil count daily c. preventing exposure of the child to infection d. offering sips of water when administering the med

c. preventing exposure of the child to infection

Which statements indicate effective discharge teaching for a client w/ osteomyelitis? SATA a. "I will take the antibiotic at the same time every day" b. "I will take the antibiotic regularly until my symptoms subside" c. "I will take the antibiotic w/ food if I develop gastric distress when on the antibiotic" d. "I will notify my HCP and stop taking the med if I develop a rash or SOB" e. "I will need to change my diet to avoid milk and ilk products while on these antibiotics"

a. "I will take the antibiotic at the same time every day" c. "I will take the antibiotic w/ food if I develop gastric distress when on the antibiotic" d. "I will notify my HCP and stop taking the med if I develop a rash or SOB"

A child is prescribed insulin glargine before breakfast. Which instruction is most appropriate for the nurse to give the parents regarding a bedtime snack? a. "offer a snack to prevent hypoglycemia during the night" b. "give the child a snack if signs of hyperglycemia are present" c. "avoid a snack b/c the child is being treated w/ long-acting insulin" d. "keep a snack at the bedside in case the child gets hungry during the night"

a. "offer a snack to prevent hypoglycemia during the night"

The HCP prescribes peak and trough levels after initiation of IV antibiotic therapy. The client asks why these blood tests are necessary. Which reason would the nurse provide? a. "they determine if the dosage of the medication is adequate" b. "they defect if you are having an allergic reaction to the med" c. "the tests permit blood culture specimens to be obtained when the med is at its lowest level" d. "these allow comparison of your fever to changes in the antibiotic level"

a. "they determine if the dosage of the medication is adequate"

A client has a prescription for nitrofurantoin 50mg PO q-evening to manage recurrent UTIs. Which instruction would the nurse give to the client? a. "increase your intake of fluids" b. "strain your urine for crystals and stones" c. "stop taking the med if your urinary output increases d. "this may turn your urine green"

a. "increase your intake of fluids"

A continuous insulin infusion is started on an adolescent w/ a bg level of 700mg/dL (38.9 mmol/L). Which complication would the nurse make a priority of detecting while the adolescent is receiving the infusion? a. hypovolemia b. hypokalemia c. hypernatremia d. hypercalcemia

b. hypokalemia

The nurse admins a tube of glucose gel to client who is hypoglycemia. Which explanation would the nurse share regarding the reversal of hypoglycemia? a. It liberates glucose from hepatic stores of glycogen b. it provides a glucose source that is rapidly absorbed c. insulin action is blocked as it completes for tissue sites d. glycogen is supplied to the brain as well as other vital organs

b. it provides a glucose source that is rapidly absorbed

Which criteria would the nurse consider when determining if an infection is a HAI? a. originated primarily from an exogenous source b. is associated w/ a med-resistant microorganism c. occurred in conjunction w/ treatment for an illness d. still has the infection despite completing the prescribed therapy

c. occurred in conjunction w/ treatment for an illness

The nurse is teaching a school-age child how to us an insulin pump. Which instruction by the nurse is most important for the child to understand? a. the needle must be changed everyday b. a bg check is necessary once a day c. the pump is an attempt to mimic the way a healthy pancreas works d. SQ pockets near the abd are used to implant the pump

c. the pump is an attempt to mimic the way a healthy pancreas works

A client w/ t2d has been receiving insulin in the hospital while being treated for sepsis. The client's infection is resolving and the primary HCP writes a prescription to discontinue the 0700 dose of insulin and to administer glyburide 5mg BID. After administering the glyburide at 0830, the nurse sees that the insulin had already been administered at 0700. Which initial action would the nurse take? a. measure the vs b. notify the primary HCP c. administer 15g of fast acting carbs d. check bg for hypoglycemia

d. check bg for hypoglycemia

A client who receives NPH insulin q-morning reports feeling nervous at 1630. The nurse observes that the client's skin is moist and cool. Which condition is most likely experiencing? a. hyperosmolar hyperglycemic nonketotic state b. ketoacidosis c. glycogenesis d. hypoglycemia

d. hypoglycemia

The nurse plans to teach a fifth-grader w/ T1D how to self-administer lispro and glargine insulin. Which action would the nurse include in the teaching plan? a. alternate the sites until the best one to use is found b. self-admin the inj after being taught the technique c. draw up the insulin glargine and then draw up the insulin lispro d. learn to use the needle and syringe by practicing on an insulin pad first

d. learn to use the needle and syringe by practicing on an insulin pad first

When a client is receiving dexamethasone for adrenocortical insufficiency, which would the nurse take to monitor for an adverse effect of the med? a. auscultate for bowel sounds b. assess deep tendon reflexes c. culture resp secretions d. measure bg levels

d. measure bg levels