Pharmacology NCLEX Questions

A client is newly diagnosed with hypothyroidism. Levothyroxine (Synthroid) is prescribed. The nurse who plans to teach this client about the medication should include that the appropriate method for taking the medication is:

4. On an empty stomach

A client is having trouble remembering his prescribed medication regimen. Which statement by the nurse is therapeutic?

4. "Let me go over your prescribed medications with you again."

A nurse has a prescription to give a dose of Rho(D) immune globulin (RhoGAM) to a client who has delivered an infant. The nurse understands that this medication will prevent the next infant from experiencing which of the following?

1. Being affected by Rh incompatibility

A client with cancer has received a course of chemotherapy with fluorouracil (Adrucil). The nurse should plan to tell the client which of the following?

1. "Do not get any immunizations without health care provider approval."

A nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which of the following statements, if made by the mother, indicates an understanding of the use of this medication?

1. "I need to wash the sites gently before I apply the medication."

A nurse is administering a dose of a prescribed diuretic to an assigned client. The nurse would plan to monitor the client for hypokalemia as a side effect of therapy if the client were receiving which of the following medications?

1. Bumetanide

A nurse is caring for a client in labor. The nurse reviews the health care provider's prescriptions and notes that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that the action of this medication is to:

1. Decrease pain.

A client is scheduled to receive chemotherapy with a group of medications, one of which is asparaginase (Elspar). The nurse anticipates that this medication will be removed from the regimen after noting which of the following disorders in the client's medical record?

4. Pancreatitis

A nurse caring for a client taking tamsulosin (Flomax) determines that which of the following findings indicates the need for follow-up?

4. Pulse rate of 120 beats per minute

A nurse is caring for a client who has been prescribed gabapentin (Neurontin) and is monitoring for adverse effects of the medication. Which of the following findings would indicate a potential adverse effect?

2. Slurred speech

A nurse is caring for a client in the oncology unit who has developed stomatitis during chemotherapy. The nurse would plan which of the following measures to treat this complication?

A nurse is caring for a client in the oncology unit who has developed stomatitis during chemotherapy. The nurse would plan which of the following measures to treat this complication?

A client in renal failure is receiving epoetin alfa (Epogen). The nurse would monitor this client for which adverse reaction to this medication?

2. Hypertension

A client taking theophylline (Theo-24) has a serum theophylline level of 15 mcg/mL. The nurse interprets that this result is:

2. In the middle of the therapeutic range

A client diagnosed with diabetes insipidus is beginning medication therapy with lypressin. The nurse teaches the client that this medication is taken:

3. Intranasally to promote water reabsorption

A client with recurrent constipation has begun using psyllium (Metamucil). The nurse tells this client that this medication should be taken with:

4. A full glass of liquid, followed by a second glass of liquid

A nurse has just been given a prescription to administer albuterol (Proventil HFA) to a client. The nurse evaluates the effectiveness of the medication by noting which of the following before and during therapy?

1. Dyspnea and lung sounds

A client is receiving tacrolimus (Prograf) to prevent organ rejection. The nurse expects to administer the dose with which of the following medications that is also normally prescribed?

1. Prednisone

A nurse is providing instructions to a client regarding epoetin alfa (Epogen) that will be administered subcutaneously by the client at home. The nurse tells the client to:

1. Refrigerate the medication.

A client with breast cancer has been given a prescription for cyclophosphamide. The nurse determines that the client understands the proper use of the medication if the client states that she needs to:

4. Increase fluid intake to 2 to 3 L/day.

A nurse is assisting in the care of a client who is being evaluated for possible myasthenia gravis. The health care provider gives a test dose of edrophonium (Enlon). The nurse recalls that the client would have which of the following reactions if the client actually does have this disease?

1. An increase in muscle strength within 1 to 3 minutes

A nurse is caring for a client with a burn injury to the lower legs. Silver sulfadiazine (Silvadene) is prescribed to be applied to the sites of injury. Which of the following indicates the appropriate method to apply this medication?

1. Apply to cleansed, debrided wounds as prescribed.

A client is beginning to take trimethoprim-sulfamethoxazole (Bactrim) for a recurrent urinary tract infection (UTI). The nurse would give the client which of the following instructions regarding this medication?

2. "Take each dose with 8 oz of water and drink extra water each day."

A nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Before administering the medication, the nurse routinely screens for which manifestations that could indicate early signs of digoxin toxicity?

4. Loss of appetite, nausea, and vomiting and nausea

A nurse is administering alendronate (Fosamax) to a client. What nursing intervention is most important for the nurse to consider when giving this medication?

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

A client receiving desmopressin (DDAVP) begins to complain of a headache. The nurse notes that the client is listless and falls asleep easily. The nurse interprets that the client is most likely experiencing which of the following?

1. Adverse medication effects

A health care provider has written a prescription for ranitidine (Zantac) 300 mg once daily on the client's discharge medication list. The nurse plans to instruct the client to take the medication at which of the following times?

1. At bedtime

A nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin sodium (Coumadin). The nurse reminds the client to do which of the following?

1. Avoid taking products containing acetylsalicylic acid (aspirin).

A nurse is monitoring a child who is receiving calcium disodium edetate (EDTA) for the treatment of lead poisoning. The nurse reviews the laboratory results of the child during treatment with this medication and is particularly concerned with monitoring which laboratory test result?

1. Blood urea nitrogen

Calcitriol (Rocaltrol) is prescribed for the client with hypocalcemia. The nurse instructs the client to avoid excessive amounts of which of the following food items that interfere with calcium absorption?

1. Bran

A client with chronic glaucoma is being started on medication therapy with acetazolamide. The nurse teaches the client that which symptoms that can occur early in use subsides or disappears in time?

1. Diuresis

A licensed practical nurse (LPN) is assisting in the care of a pregnant teenaged client with preeclampsia receiving magnesium sulfate. The LPN plans to notify the registered nurse immediately if which sign of magnesium toxicity is noted?

1. Respiratory rate of 10 breaths per minute

A nurse is assigned to care for a client with metastatic breast cancer who is taking tamoxifen citrate. The nurse monitors for which of the following trends in laboratory values that could indicate an adverse effect?

1. Rising serum calcium level

A postoperative client has received a dose of naloxone for respiratory depression. The nurse anticipates that the client will have which of the following additional effects from the administration of this medication?

1. Sudden increase in pain

Aluminum hydroxide (Amphojel) is prescribed for the client with chronic renal failure (CRF). The nurse instructs the client to take this medication:

1. With meals

A nurse is reviewing the health care provider's prescription sheet for the preoperative client, which states that the client must be on nothing per mouth (NPO) status after midnight. The nurse would clarify whether which of the following medications should be given to the client and not withheld?

2. Atenolol (Tenormin)

A client with myocardial infarction is a candidate for alteplase (Activase) therapy. The nurse assisting in the care of this client is aware that it will be necessary to monitor for which frequent adverse effect if the client receives this treatment?

2. Bleeding

A nurse is administering a dose of prochlorperazine to a client for nausea and vomiting. The nurse tells the client to report which of the following symptoms, which is a frequent side effect of this medication?

2. Blurred vision

A client with a burn injury is applying mafenide acetate (Sulfamylon) to the wound. The client calls the health care provider's office and tells the nurse that the medication is uncomfortable and is causing a burning sensation. The nurse instructs the client to:

2. Continue with the treatment because this is expected

A client who has sustained an eye injury has been prescribed corticosteroid eye drops. The nurse would most carefully monitor for side effects of this medication if the client has which of the following health problems listed on the medical record?

2. Diabetes mellitus

A client has been prescribed vancomycin (Vancocin) 5 mL by mouth to be taken twice daily. The nurse plans to monitor which of the following specifically associated with effectiveness of this medication?

3. Therapeutic serum levels

A nurse is caring for a child with congestive heart failure and provides instructions to the mother regarding the procedure for administration of the prescribed digoxin (Lanoxin). Which statement by the mother indicates a need for further instruction?

3. "I can mix the medication with food."

A nurse is providing instructions to an adolescent who is taking phenytoin (Dilantin) for the control of seizures. Which statement by the adolescent indicates a need for further teaching regarding the medication?

3. "If my gums become sore, I need to stop the medication."

A health care provider has written a prescription for calcium carbonate for the client with hypocalcemia. The nurse preparing to administer the medication schedules the medication to be given:

3. Two hours after meals

A glucocorticoid is prescribed for a client with adrenal insufficiency, and the nurse provides medication instructions to the client. The nurse determines that the client needs additional instructions if the client states to:

4. Discontinue the medication when symptoms subside.

A client is taking brompheniramine (BroveX). The nurse teaches the client to expect which of the following side effects of this medication?

4. Drowsiness

A client with a history of spinal cord injury is beginning medication therapy with baclofen (Lioresal). The nurse who is providing medication information should caution the client about which side effect of this medication?

4. Drowsiness

A nurse is assisting in admitting a child who arrived from the emergency department after treatment for acetaminophen (Tylenol) overdose. The nurse reviews the child's record and expects to note that the child received which of the following for the acetaminophen overdose?

4. Acetylcysteine (Mucomyst)

A client is scheduled to receive digoxin (Lanoxin), 0.125 mg by mouth. The licensed practical nurse (LPN) reads the medication label and notes that each tablet contains 0.25 mg. The LPN should do which of the following?

4. Administer half of a medication tablet.

A child is diagnosed with tinea capitis of the scalp. Oral griseofulvin (Gris-PEG) has been prescribed for the child, and the nurse provides instructions regarding the administration of the medication. Which of the following instructions would the nurse provide to the mother?

4. Administer the medication with milk.

A client has a prescription to receive albuterol (Proventil HFA) two puffs and beclomethasone dipropionate (Qvar) two puffs by metered-dose inhaler. The nurse plans to give these medications most effectively by:

4. Administering the albuterol before the beclomethasone dipropionate

A client with eczema has a prescription for a topical corticosteroid. The nurse cautions the client to use the product carefully in which of the following areas where the risk of systemic absorption is greater?

4. Face

A child with a right-to-left cardiac shunt is receiving propranolol (Inderal-LA). The health care provider visits the child and writes prescriptions in the child's record. The licensed practical nurse (LPN) reviews the prescriptions and notes that the child is placed on a nothing-by-mouth (NPO) status. The LPN consults with the registered nurse and prepares to monitor which of the following most closely?

4. Glucose level

A nurse tells a client with leukemia that allopurinol (Zyloprim) has been added to the medication list. The client is currently receiving busulfan (Myleran). When the client asks the purpose of the new medication, the nurse responds that the allopurinol is intended to prevent:

4. Hyperuricemia

A client has a prescription for sucralfate (Carafate) 1 g by mouth four times daily. The nurse writes in the medication record to administer the medication at which of the following times?

4. One hour before meals and at bedtime

A nurse has a routine prescription to instill erythromycin ointment (Ilotycin) into the eyes of a newborn. The nurse explains to the parents that the purpose of the medication is to:

4. Protect the newborn from contracting an eye infection from the birth process.

A client with a urinary tract infection is beginning medication therapy with nitrofurantoin (Macrodantin). The nurse reminds the client to avoid which food item while taking this medication to maintain an acid-ash diet?

4. Rhubarb

A client diagnosed with hyperthyroidism will be taking propylthiouracil (PTU). The nurse provides medication instructions and determines that the client understands the information if the client states that it is most important to report which of the following symptoms to the health care provider?

4. Sore throat

A nurse has a prescription to give a first dose of hydrochlorothiazide (HydroDIURIL) to an assigned client. The nurse would question the prescription if the client had a history of allergy to:

4. Sulfa drugs

A licensed practical nurse (LPN) is assisting in the care of a client who is receiving oxytocin (Pitocin) to induce labor. The LPN plans to notify the registered nurse immediately if which of the following is noted?

4. The uterus becomes hyperstimulated.

A nurse is preparing to give instructions to the client who has been given a prescription for diphenoxylate with atropine (Lomotil). The nurse teaches the client to:

3. Not exceed recommended dose because it can be habit forming.

A client has begun taking lansoprazole (Prevacid). The nurse monitors for which of the following intended effects of this medication?

3. Relief of nighttime heartburn

A client with respiratory congestion is scheduled to receive acetylcysteine (Mucomyst) 20% solution diluted in 0.9% normal saline by nebulizer. The nurse checks the client's room to ensure that which of the following equipment is available for use as needed following administration of this medication?

3. Suction equipment

A client with dermatitis has been prescribed a topical corticosteroid for use on the affected areas, and the nurse has provided instructions about the use of this medication. Which statement by the client indicates the need for further instructions?

1. "I will apply a bandage over the site after applying the medication."

A client with peptic ulcer disease has a new prescription for propantheline (Pro-Banthine). The nurse instructs the client to take this medication:

1. 30 minutes before meals

A nurse has a prescription to give ear drops to a 2-year-old child. The nurse positions the child's ear properly by pulling the pinna of the ear:

2. Downward and backward

A client has been given a prescription for trimethoprim (Proloprim). The nurse determines that the client understands how to use the medication properly if the client states an intention to:

2. Drink extra fluids while taking the medication.

A client with a urinary tract infection with dysuria is given a prescription for phenazopyridine hydrochloride (Pyridium) for symptom relief. The nurse reinforces medication instructions with this client by reminding the client to:

2. Expect the urine to become reddish orange.

A client with heart disease who is taking digoxin (Lanoxin) complains of having no appetite. The nurse notes that the client also has a low serum potassium (K+) level. The nurse checks the results of the digoxin level obtained this morning, anticipating that the level is likely to be:

2. High

A nurse has provided diabetic teaching with the family of a client newly diagnosed with diabetes. The nurse determines that the family understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat:

2. Hypoglycemia from insulin overdose

A female client undergoing chemotherapy with intravenous vincristine sulfate (Oncovin) has been given information about the treatment. The nurse determines that the client has adequate understanding of the side effects of treatment if the client states that her hair:

2. May be lost temporarily but may grow back with a different color and texture

A nurse assisting in the care of a newborn has a standing prescription to administer the hepatitis B vaccine to the infant. The nurse should plan to do which of the following when carrying out this prescription?

2. Obtain written parental consent.

A licensed practical nurse has observed a client self-administer a dose of an adrenergic bronchodilator via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. Which action should the nurse take first?

2. Report the client's symptoms to the RN.

A registered nurse has administered a dose of naloxone intravenously to a client with intravenous opioid overdose. The licensed practical nurse assigned to assist in monitoring the client ensures that which of the following equipment is available in the immediate vicinity of the client?

2. Resuscitation equipment

A client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite (Dakin solution) to be used in the care of the wound. The nurse would do which of the following while using this solution?

2. Rinse off immediately following irrigation.

A client has been instructed by the healthcare provider to alternate the use of hydrogen peroxide and glycerin eardrops to loosen an impacted accumulation of earwax. The nurse gives the client which of the following directions to accomplish this daily procedure safely and independently?

3. "Use the solutions at body temperature for 7 to 14 days."

A client has been given a prescription for metoclopramide (Reglan) four times a day. The nurse determines that the client is taking the medication at optimal times if the client reports using the medication:

3. 30 minutes before meals and at bedtime

A client asks the nurse about which product should be taken for headache. The client is taking lansoprazole (Prevacid) for long-term management of Zollinger-Ellison syndrome. The nurse determines that which of the following would be the best choice for this client?

3. Acetaminophen (Tylenol)

A nurse is preparing a subcutaneous dose of bethanechol chloride (Urecholine) prescribed for a client with urinary retention. Before giving the dose, the nurse checks to see that which of the following medications is available on the emergency cart for use if needed?

3. Atropine sulfate

A licensed practical nurse (LPN) is reviewing the medication list of the client with a history of glaucoma. The LPN would consult with the registered nurse if which of the following medications is prescribed for this client?

3. Atropine sulfate (Isopto Atropine)

A nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse checks to see that which of the following medications is available in the stock medication supply area for possible use to reverse this elevation?

3. Calcitonin (Calcimar)

A long-term care nurse is caring for an older client taking cimetidine (Tagamet). The nurse observes this client frequently for which most frequent central nervous system (CNS) side effect of this medication?

3. Confusion

The nurse administering medications to a group of clients notes a prescription to give a subcutaneous dose of heparin sodium. The nurse should do which of the following to give this medication safely?

3. Give the injection using a 25- to 27-gauge, ⅝-inch needle.

A client diagnosed with scabies has lindane prescribed. The nurse should plan to include which of the following pieces of information when telling the client about the use of this product?

3. Leave the cream on for 8 to 12 hours and then remove by washing.

A client is being discharged to home with a prescription for eye drops to be given in the left eye. The nurse has shown the client how to self-administer the drops. The nurse determines that the client needs further instruction if the client does which of the following during a return demonstration?

3. Lies supine, pulls up on the upper lid, and puts the drop in the upper lid

A nurse is caring for a client taking tolbutamide (Orinase) who has just been diagnosed with a urinary tract infection. The health care provider plans to treat the infection with sulfamethoxazole. The nurse expects that because of medication interactions, the health care provider will prescribe a:

3. Lower dose of the tolbutamide

A client who has just been diagnosed with glaucoma has been given a prescription for a miotic medication. When teaching the client about medication effects, the nurse plans to tell the client that the medication will:

3. Lower intraocular pressure and enhance blood flow to the retina.

A client experiencing preterm labor at 29 weeks' gestation has been admitted to the hospital. The client has a prescription to receive betamethasone. The nurse explains to the client that the medication will do which of the following?

3. Promote maturation of the fetal lungs.

A nurse is concerned that a client may experience systemic effects from a β-blocker ophthalmic solution. The nurse observes the client self-administer the medication to be sure that the client:

4. Applies digital pressure to the lacrimal sac for 1 to 2 minutes after instillation

Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse is preparing to provide instructions to the client and spouse regarding the wound treatment. Which of the following should the nurse include in the instructions?

4. Apply once a day and cover the wound with a sterile dressing.

A client recently began medication therapy with propranolol (Inderal-LA). The nurse would be most concerned after noting the presence of which of the following in this client?

4. Audible expiratory wheezes

A nurse is providing vaccine information to a second-day postpartum client who received a rubella vaccine. The nurse reminds the client to avoid which of the following after receiving this vaccine?

4. Becoming pregnant for 2 to 3 months

A licensed practical nurse (LPN) is assisting in the care of a client in preterm labor who is being started on intravenous magnesium sulfate to stop the contractions. The LPN checks to see that which of the following is available on the unit as an antidote to magnesium sulfate?

4. Calcium gluconate

A client who exhibits fatigue, lack of energy, constipation, and depression is diagnosed with hypothyroidism. The health care provider prescribes levothyroxine (Synthroid). To increase the likelihood of medication compliance in the early course of treatment, the nurse plans to alert the client that:

3. The full therapeutic effect may take 1 to 3 weeks.

A nurse is teaching a mother how to administer ear drops to an infant. The nurse plans to demonstrate by pulling the ear:

2. Down and back and directing the solution toward the wall of the canal

A nurse is administering gentamicin sulfate (Garamycin) ophthalmic ointment to a client. After instilling the ointment, the nurse instructs the client to close the eye and:

2. Roll the eyeball in all directions.

A client has a new prescription to take guaifenesin (Humibid) every 4 hours as needed. The nurse giving medication instructions to the client tells the client to be sure to:

3. Take the tablet with a full glass of water.

Allopurinol (Zyloprim) has been prescribed for the client, and the client asks the nurse about the action of the medication. The nurse responds, knowing that it:

4. Decreases uric acid production and reduces uric acid concentrations in both the serum and urine

A client who has developed atrial fibrillation that is not responding to medication therapy has begun taking warfarin (Coumadin). The nurse is performing dietary discharge teaching with the client. The nurse would plan to teach the client to avoid which of the following foods while taking this medication?

4. Broccoli

A client with psoriasis has been prescribed coal tar for use in the treatment of the disorder. In teaching the client about the medication, the nurse incorporates the understanding that this medication:

4. Can stain the skin and hair

A health care provider has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse teaches the client about the medication and tells the client to monitor for:

4. Constipation