Pharmacology Clear and Simple: Test One (Ch. 1-10)

An 18-year-old patient calls a physician's office to request a refill for birth control pills. Which response by the nurse is best? A) "The physician must see you at least every 6 months to provide prescription refills." B) "If you've been seen by the doctor in the last year, a prescription refill can be called to your pharmacy." C) "All birth control medications require a hand-written prescription, so you will need to pick this up at the desk at your convenience." D) "Are you sexually active?"

) "If you've been seen by the doctor in the last year, a prescription refill can be called to your pharmacy."

The nurse is preparing to provide sliding scale insulin coverage to a client with diabetes. The client's blood sugar is 240 g/dL. The sliding scale indicates the client should receive 8 units of insulin. The insulin is provided in a multi-dose vial with a concentration of 100 units/10 mL. How many mL of insulin will the nurse provide?

0.8 mL

The nurse is providing ondansetron (Zofran) 4 mg as an intravenous injection. The pharmacy provides ondansetron in 8 mg/2 mL vials. How much medication will the nurse draw up? Provide the answer in mL.

1 mL

The nurse receives orders to start metronidazole (Flagyl) 50 mg/kg/24 hours divided into three equal doses for a child that weighs 33 lbs. The medication is provided in 250-mg tablets. How many tablets will the nurse provide with each dose?

1 tablet

The nurse is mixing diluent with a powdered medication. The package directions instruct the nurse to mix 3 mL of sterile water to achieve a concentration of 4 mg/mL. The client's dose is 6 mg. How many mL will the nurse withdraw to provide to the client? Round to the nearest tenth.

1.5 mL

While providing care to a client with advanced neuroblastoma, the nurse is preparing chemotherapy dosed at 75 mg/m2. The client's body surface area is 1.8 m2. What dose (in mg) of chemotherapy will be provided?

135 mg

The nurse is tallying intake for a client receiving kidney dialysis who is on a 1,200-mL fluid restriction. The client has had 2 cups of coffee, 1 cup of water, 4 oz gelatin, 1/3 of a 10 oz cup of soup, and half a carton (240 mL) of milk. How much additional fluid in mL can the client consume for the remainder of the day?

140 mL

While preparing to dispense a dose of liquid medication for a client with a gastrostomy tube, the nurse notes the ordered dose is 15 mL. How many cc will the nurse draw into the cath-tipped syringe when dispensing the medication?

15 cc

A client has been ordered to receive IM ceftazidime (Ceptaz). The 1 gram vial is to be mixed with 3 mL sterile diluent to create a final solution concentration of 250 mg/mL. The client's dose is 500 mg. How many mL will the nurse provide?

2 mL

An antibiotic is reconstituted with 29 mL distilled water to create 50 mL of solution with a concentration of 100 mg/5 mL. How much medication in mL would the nurse obtain to provide a dose of 45 mg? (Round to the nearest hundredth).

2.25 mL

Meloxicam (Mobic) is dispensed in solution with 7.5 mg/5 mL. The physician has ordered 0.125 mg/kg daily for a child with juvenile arthritis who weighs 68 lbs. How many mL will the nurse provide? (Round to the nearest tenth).

2.6 mL

The drug label of cefpodoxime (Vantin) indicates it should be suspended in 44 mL of distilled water to create 75 mL with a final concentration of 50 mg/5 mL. The client's dose is 10 mg/kg/day divided into two equal doses. The client weighs 88 lbs. How much medication in mL will the nurse provide with each dose? (Round to the nearest full mL).

20 mL

The nurse is preparing to provide losartan (Cozaar) suspension (2.5 mg/mL) for a client whose dose is 50 mg. How many mL will be provided?

20 mL

The nurse is caring for a client placed on a 2,000-calorie diet. If two snacks are responsible for 20% of the caloric intake, how many calories can be consumed with each snack?

200 calories

While attempting to track the intake of an elderly client, the nurse asks the client to identify what the client drank that day. The client reports, "I had a small cup of tea, a juice glass full of juice, and 2 cups of milk." The nurse would record how many oz for this client's intake?

26 oz

All chemotherapy orders are to be double-checked by two nurses. Orders read, "Cisplatin 20 mg/m2." The nurse has 100 mg/100 mL vial of cisplatin and the client's body surface area is 1.4 m2. How much cisplatin in mL will the nurse draw up for infusion?

28 mL

The nurse is preparing to provide finasteride (Proscar) 5 mg daily in combination with doxazosin (Cardura) 2 mg daily to a client with benign prostatic hypertrophy. The pharmacy provides the finasteride in a 5-mg tablet and the doxazosin in a 1-mg tablet. How many pills will the nurse provide?

3 pills

The charge nurse is doing client rounds and notes a client is receiving blood at a set rate of 100 mL/hr. The blood transfusion has finished and 500 mL of 0.9% NS is hanging as backup. In order to complete the transfusion, the nurse will flush the tubing by infusing 50 mL of the 0.9% NS over 10 minutes. What rate (mL/hr) should the pump be set to for the 0.9% NS infusion?

300 mL/hr

The nursing instructor is supervising nursing student medication provision at 4 p.m. The client has the following medications scheduled: 0800—acetazolamide (Diamox), carvedilol (Coreg), and lisinopril (Zestril) 1000—metoclopramide (Regland) prn 1100—polyethylene glycol (Miralax), lovenox (Fragmin) 1400—metoclopramide (Reglan) prn 1600—lisinopril (Zestril) 2000—alpraxolam, metoclopramide (Reglan) prn Which medications will the student nurse provide at this time? 1. Metoclopramide prn 2. Alprazolam and metoclopramide prn 3. Polyethylene glycol and lovenox 4. Lisinopril

4

The nurse is providing care for a newborn that weighs 8 lb 8 oz. The physician has ordered medications based on a kg weight. How much does the infant weigh in kg? Round to the nearest whole number.

4 kg

While working in the pediatric clinic, the nurse receives a call from a client trying to figure out how much infant acetaminophen (Tylenol) to give to her child. The doctor has prescribed 45 mg every 4 hours. The medication is provided in 60 mg/5 mL concentration. How much medication (in mL) should the client provide per dose? (Round to the nearest mL)

4 mL

A client consumes 1/2 cup grape juice, 2/3 of a 10 oz bowl of broth, 1/4 of a 4 oz bowl of gelatin, and 1/3 a carton of milk, which holds 240 mL. Calculate the client's intake in mL.

430 mL

While working in the pediatric clinic, the nurse examines the mouth of a 5-year-old patient being treated for leukemia and notes white patches and scattered ecchymosis. The nurse suspects the child has thrush and expects the physician to order fluconazole (Diflucan). This medication is typically dosed at 3 mg/kg. The child weighs 42 lb. How many mg will be in each dose? (Round to the nearest 10 mg).

60 mg

The physician recommends a teenager start taking 600 mg ibuprofen (Advil) tid starting 2 days prior to her menstrual cycle and that she continue the medication for one week. The medication comes in 200-mg strength tablets. How many tablets will the client consume during the week?

63 tablets

The nurse is caring for a client who is to receive cefoperazone (Cefodbid) 1.5 g in 100 mL normal saline intravenously over 30 minutes. The nurse begins the infusion and a little while later the client calls to report itching so the nurse stops the infusion. The pump reading has recorded 44 mL infused. Approximately how much medication (in mg) did the client receive?

660 mg

The physician has ordered a child's antibiotic dose as 5 mg/kg. The child weighs 14 kg. The antibiotic is provided in a vial with 10 mg/mL. How many mL of antibiotic will be dispensed? Round to the nearest whole number.

7 mL

While removing the dinner tray from a client's room, the nurse notes the client drank 1 cup of water, 6 oz of beef broth, 4 oz of gelatin, 120 mL of juice and 1 2-oz popsicle. What would the nurse record for intake in mL?

720 mL

Trimethoprim and sulfamethoxazole (Septra) suspension contains 200 mg sulfamethaxazole in each teaspoon. The physician has ordered 2 teaspoons every 12 hours. What is the total daily dose of sulfamethaxazole in mg?

800 mg

A 16-year-old client comes to the urgent care clinic with symptoms of tonsillitis. The client tells the nurse she takes tetracycline (Doxycycline) daily for the treatment of acne. The nurse would be most concerned if the health care provider prescribed which of the following? A) Amoxicillin clavulanate (Augmentin) B) Cefdinir (Omnicef) C) Cefixime (Suprax) D) Ciprofloxacin (Cipro)

A) Amoxicillin clavulanate (Augmentin)

The nurse is caring for a client starting diuretic therapy and is placed on strict intake and output measurements. In counseling this client to maintain at least 1,500 mL intake per day, which beverages should the nurse instruct the client to avoid? A) Citrus juices and alcohol B) Coffee, beer, and most soda pop C) Tomato juice, diet drinks, and lemonade D) Electrolyte-based drinks, tea, and artificial sweeteners

B) Coffee, beer, and most soda pop

The nurse is providing care for a client experiencing muscle spasms. The physician has ordered cyclobenzaprine (Flexeril). The nurse would inform the client to anticipate which of the following side effects? A) Hypocalcemia and hypotension B) Dizziness and drowsiness C) Nausea and headache D) Flaccidity and urinary retention

B) Dizziness and drowsiness

The nurse provides a client admitted with gastroesophageal reflux a dose of intravenous pantoprazole (Protonix). Fifteen minutes later, the client calls for help and is gasping for breath. Emergency measures are instituted and the client is transferred to the intensive care unit. Which action should be included in the nurse's follow-up activities? A) Notify the nursing supervisor that the client experienced a common side effect to the drug. B) Identify the episode as an adverse reaction and ensure it is reported to the FDA. C) Call the hospital administrator to report an act of medication fraud. D) Contact the local news channel to arrange an investigation.

B) Identify the episode as an adverse reaction and ensure it is reported to the FDA.

While caring for clients on the medical unit, the nurse would see which of the following clients first? A) A 28-year-old patient with HIV who has a temperature of 99.2°F B) A 54-year-old patient with diverticulitis whose diet was just advanced to solid food C) A 61-year-old patient who takes ibuprofen for arthritis complaining of severe stomach pain D) A 37-year-old patient with a kidney stone who is due for pain medication in 20 minutes

C) A 61-year-old patient who takes ibuprofen for arthritis complaining of severe stomach pain

While shopping for an over-the-counter cough suppressant, the nurse identifies the medication will be classified as: A) A Schedule I medication B) A Schedule III medication C) A Schedule V medication D) Nonscheduled medication

C) A Schedule V medication

The nurse initiates therapy with normal saline nasal spray 2 sprays per nostril qid. Prior to administration, the best action by the nurse is: A) Have the client tilt the head forward and down toward the chin B) Determine which nostril is most patent C) Verify the dosage on the multi-dose vial D) Have the client blow his or her nose

D) Have the client blow his or her nose

The nurse is attempting to flush an IV catheter without success. The site has no redness, swelling, or pain. The nurse determines the difficulty is most likely due to which of the following? A) Air emboli B) Infiltration C) Phlebitis D) Thrombus

D) Thrombus

The nurse is preparing to provide medications to a client who recently had a stroke and has right-sided weakness. The previous nurse reported the client is able to take pills if they are crushed and placed in applesauce. Which of the following should the nurse plan to crush? (Select all that apply.) A) Enteric-coated aspirin tablet B) Robitussin cough syrup C) Adderall XR capsule D) Extended-release morphine E) Acetaminophen (Tylenol) tablet

E) Acetaminophen (Tylenol) tablet

The nurse is instructing a client diagnosed with diabetes on self-injection technique for insulin. Which angle of insertion will the nurse teach the client? A) 15 degrees B) 30 degrees C) 45 degrees D) 90 degrees

C) 45 degrees

While caring for a client on a 1,700-calorie diet restriction, the nurse notes the client has consumed 415 calories for breakfast. If 300 calories are allotted for beverages and snacks, how many calories remain for the client's meals?

985 calories

A client is ordered 25 mg of diphenhydramine (Benadryl) by intramuscular injection. The medication is supplied in a 1-mL vial with 50 mg dosage. How much will the nurse inject?

0.5 mL

A young girl is started on 5 mg of paroxetine (Paxil) daily. The pharmacy provides 10-mg tablets. How much will the nurse provide?

0.5 tablets

The nurse is caring for a 12-year-old patient who, after a kidney transplantation, is to receive sirolimus (Rapamune). The child weighs 38 kg and has a body surface area of 1.2 m2. The medication has been ordered at a dose of 1 mg/m2/day and is provided by pharmacy in a 60 mg/60 mL-solution mixed in glass bottle for oral provision. How many mL will the nurse provide?

1.2 mL

The nurse is passing morning meds for a client with hypertension taking fosinopril (Monopril) 30 mg. The pharmacy supplies this medication as a 20-mg tablet. How many tablets will the nurse provide?

1.5 tablets

The nurse is preparing to hang ciprofloxacin (Cipro) IVPB. The medication order is for 400 mg in 100 mL to infuse over 1 hour. What rate (mL/hr) should be set on the IV pump to ensure appropriate drug delivery?

100 mL/hr

The nurse is providing levofloxacin (Levaquin) 750 mg over 90 minutes. The antibiotic comes from pharmacy in a 150-mL solution bag. What rate (mL/hr) should be set on the IV pump to infuse the medication correctly?

100 mL/hr

The ordered antibiotic is sent from pharmacy in 50 mL of solution. The label says to infuse over 30 minutes. What rate (mL/hr) would be set on the IV pump?

100 mL/hr

While working in the pediatric clinic, the nurse weighs a 5-year-old child as 20.5 kg. The mother asks, "How much is that in pounds?" Provide the child's weight to the nearest whole pound.

45 lb

While assisting with meal planning for a client placed on an 1,800-calorie diet, the nurse plans for meals to make up 80% of the calorie consumption and wants to make each meal equivalent. How many calories should the nurse plan for each of three meals?

480 calories

The nurse is caring for a client on peritoneal dialysis. During a dialysis session, 2,000 mL of dialysate solution was infused and 1850 mL returned. The client consumed 1 cup of coffee, 120 mL of apple juice, and 1 bowl of oatmeal without milk. Calculate the client's intake in mL.

510 mL

The nurse is caring for a client who takes lisinopril (Zestril) 10 mg tid. Discharge orders include a prescription for a 30-day supply. How many pills will be in the bottle when the prescription is filled?

90 tablets

A nurse working in the oncology clinic is providing doxorubicin (Adriamycin) 60 mg/m2 to a client whose body surface area is 1.6 m2. What dose of doxorubicin (in mg) will be sent by the pharmacy?

96 mg

The nurse is providing care for a client at 32 weeks' gestation who started low-molecular heparin injections after developing a deep vein thrombosis. The client asks the nurse, "Why do I have to take a shot? Why can't I take the blood clot medicine that my dad takes orally?" Which of the following responses by the nurse is best? A) "Anything that is fat-soluble, including warfarin (Coumadin), is able to cross the placental barrier. Heparin is not fat-soluble so it doesn't cross the barrier well." B) "The placenta is easily crossed by anything you take by mouth while you are pregnant, but not by things absorbed in other ways." C) "Only water-soluble substances such as vitamins can cross the placental barrier, so you could take either medication, but heparin is cheaper." D) "They are the same medication, but the shot is absorbed faster than the pill so the doctor wants you to take daily shots."

A) "Anything that is fat-soluble, including warfarin (Coumadin), is able to cross the placental barrier. Heparin is not fat-soluble so it doesn't cross the barrier well."

A nurse working at the poison control center receives a call from a young woman babysitting for a 4-year-old child who reportedly swallowed some of the parent's medication. Which statement by the nurse is best? A) "I'm calling emergency personnel for you now." B) "What do the pills look like?" C) "Have the child drink a glass of milk." D) "What is the name of the pills?"

A) "I'm calling emergency personnel for you now."

While caring for a patient scheduled for knee replacement surgery, the nurse provides cefazolin (Ancef) as ordered 30 minutes pre-operatively. The nurse knows that teaching has been effective by which of the following client statements? A) "The antibiotic is given as a prophylactic to help reduce the risk of infection after surgery." B) "This is a palliative medication to help ease the pain from surgery." C) "This medication will replace vitamins and minerals that may be lost due to bleeding during surgery." D) "This medication will help the surgeon identify areas of bone destruction due to arthritis."

A) "The antibiotic is given as a prophylactic to help reduce the risk of infection after surgery."

A client admitted to the hospital with acute renal failure typically takes moexipril (Univasc) for hypertension. The client's creatinine clearance is 32 mL/min and the pharmacy recommends a 50% dose reduction for this medication. The client's typical dose is 7.5 mg. The nurse would expect the physician to order: A) 3.75 mg B) 2.25 mg C) 4.25 mg D) 5.75 mg

A) 3.75 mg

While teaching a client who is to begin ophthalmic ointment and drops bid, the nurse would instruct the client to place the ointment: A) Along the inner aspect of the lower eyelid B) In the eye before putting in the drops C) Along the lash line with a cotton swab D) In a circular motion along the both lids

A) Along the inner aspect of the lower eyelid

A client turns on their call light and reports his IV site is painful and seems to be leaking. Which action by the nurse is best? A) Assess the site for any local tissue damage and remove the IV. B) Attempt to flush the IV site with 3 ml of NS. C) Elevate the client's arm on a pillow and re-secure the dressing. D) Place a tourniquet above the insertion site and cleanse the area with alcohol prep.

A) Assess the site for any local tissue damage and remove the IV.

A client with diabetes mellitus is ordered sliding scale insulin glulisine (Apidra) 2 to 10 units ac and hs based on blood glucose results. The nurse will need to check the client's blood sugar: A) Before each meal and at bedtime B) Fasting in the morning and again at bedtime C) Just before breakfast and again at dinner D) After each meal

A) Before each meal and at bedtime

When providing medications from floor stock to a client on the Alzheimer's unit of a long-term-care facility, the nurse demonstrates the principle of right drug by which of the following? A) Checks the label before taking the medication out of the cabinet, checks the label before pouring the medication, checks the label before placing the bottle back in the cabinet B) Checks the label before taking the medication out of the cabinet, checks the label before pouring the medication, checks the label before leaving the medication room C) Checks the label after removing the bottle from the cabinet, checks the label after pouring the dose of medication, checks the label before closing the cabinet door D) Checks the label while removing the bottle from the cabinet, checks the label after pouring the dose of medication, checks the label while replacing the bottle in the cabinet

A) Checks the label before taking the medication out of the cabinet, checks the label before pouring the medication, checks the label before placing the bottle back in the cabinet

The nurse is providing medications to a client with a gastrostomy tube. Diclofenac (Cambia) has been ordered. Prior to administration, the nurse should take which of the following actions? A) Ensure that the medication comes as a liquid preparation. B) Obtain a 3-mL syringe and needle with a safety device. C) Document the medication provision. D) Ask the client to state her name and room number.

A) Ensure that the medication comes as a liquid preparation.

When preparing to provide an IM injection at the ventrogluteal site, the nurse would identify which landmarks? A) Greater trochanter, anterior iliac spine, and iliac crest B) Acromial process, scapula, and humerus C) Greater trochanter of the femur and lateral femoral condyle D) Iliac crest and gluteus minimum muscle

A) Greater trochanter, anterior iliac spine, and iliac crest

While caring for a patient with a history of hypothyroidism, the nurse expects which of the following medications to be included in the patient's medication list? A) Levothyroxine sodium (Synthroid) B) Estrogen (Estradiol) C) Iodine 131 D) Carbimazole (Methimazole)

A) Levothyroxine sodium (Synthroid)

The nurse is providing care to a client with HIV who has been prescribed fosamprenavir (Lexiva). Which of the following statements by the client indicates that further teaching is necessary? A) "The metabolites of this medication may be excreted in active form." B) "I'm glad my kidneys work so well; otherwise the medication wouldn't work." C) "This drug actually has to be broken down by my body to fight the virus." D) "Isn't it fascinating that my liver has to metabolize the drug for it to work?"

B) "I'm glad my kidneys work so well; otherwise the medication wouldn't work."

When providing ear drops for an 81-year-old patient to help soften the cerumen, which action by the nurse is best? A) Have the client lean his head back while sitting upright in a chair. B) Pull the pinna up and back to straighten the ear canal. C) Rotate the bottle gently between the hands after removing from the refrigerator. D) Observe the seven "rights" of proper medication administration.

B) Pull the pinna up and back to straighten the ear canal.

The nurse is preparing liquid acetaminophen (Tylenol). The recommended dose is 30 ml, which will be provided via the client's gastrostomy tube through which the client is currently receiving tube feeding. Which action by the nurse is best? A) Measure the liquid in a medicine cup with the meniscus at the 30 ml mark, disconnect the tube feeding, aspirate stomach contents, flush with water, instill the Tylenol, flush with water, reconnect the tube feeding B) Measure the liquid in a medicine cup with the bottom of the fluid at the 30 ml mark, disconnect the tube feeding, aspirate stomach contents, instill the Tylenol, flush with water, re-connect the tube feeding C) Measure the medication with a tablespoon, disconnect the tube feeding, flush with water, instill the Tylenol, flush with water, reconnect the tube feeding D) Measure the liquid with a syringe, disconnect the tube feeding, aspirate stomach contents, instill the Tylenol, reconnect the tube feeding

A) Measure the liquid in a medicine cup with the meniscus at the 30 ml mark, disconnect the tube feeding, aspirate stomach contents, flush with water, instill the Tylenol, flush with water, reconnect the tube feeding

When preparing to provide medication to a child with asthma using a spacing chamber, the nurse will utilize which mode of delivery? A) Metered dose inhaler B) Nebulizer C) Continuous positive pressure machine D) Mask

A) Metered dose inhaler

A co-worker tearfully confides that she is struggling with a growing dependence on sleeping medication and other drugs to maintain her work schedule on the night shift. Which action by the nurse is best? A) Refer the co-worker to the employee assistance program. B) Encourage the co-worker to switch to herbal remedies. C) Suggest the co-worker try to get a daytime position. D) Ask if the co-worker needs help with childcare.

A) Refer the co-worker to the employee assistance program.

Shortly after providing a new sleeping pill to a client on the medical unit, the nurse answers the client's call light. Which of the following findings would indicate to the nurse that the client is experiencing an anaphylactic reaction to the medication? A) The client's respiratory rate is 28 and slightly labored. B) The client complains of continued wakefulness and agitation. C) The client states that she feels nauseated and has a headache. D) The client reports feeling hot and has a rash across her chest.

A) The client's respiratory rate is 28 and slightly labored.

The nursing instructor is supervising medication administration for a client prescribed prednisone (Deltasone). The instructor would intervene if which of the following were observed? A) The student provided the medication with a glass of water. B) The student verified the client's name and birth date prior to opening the med package. C) The student checked the available dosage of medication against the order. D) The student identified side effects of the medication.

A) The student provided the medication with a glass of water.

While working in the neonatal intensive care unit, the nurse notes an infant's oxygen saturation has been 98% for the past 4 hours. The infant has been receiving oxygen at 4 L. Which of the following actions by the nurse is best? A) Turn the oxygen level down to 3 L and monitor closely to reduce the risk of eye damage. B) Leave the oxygen level at its current rate to reduce the risk of lung damage. C) Turn the oxygen level down to 2 L and monitor closely to evaluate the infant's readiness for transfer out of the ICU. D) Leave the oxygen level at its current rate and inform the parents the baby will need supplemental oxygen at home.

A) Turn the oxygen level down to 3 L and monitor closely to reduce the risk of eye damage.

A neighbor calls the nurse saying, "This bottle of infant acetaminophen (Tylenol) doesn't have a dropper; it has a little cup. How do I know how much to give to my 3-month-old daughter?" Which response by the nurse is best? A) "How much did you give your three-year-old son when he was a baby?" B) "Read the label on the back of the box to find the strength and recommended dosage." C) "Why do you need to give the baby Tylenol?" D) "Tylenol is no longer given to infants or children."

B) "Read the label on the back of the box to find the strength and recommended dosage."

The nurse is preparing potassium bicarbonate (TriLyte) for a pediatric client scheduled for a colonoscopy. The directions state to provide the prep at an estimated rate of 25 mL/kg/hr. The child weighs 55 lb. The nurse should encourage the child to drink how much of the solution each hour? A) 1 cup B) 2 cups C) 2.5 cups D) 4 cups

C) 2.5 cups

A client being seen in the outpatient clinic has been given a new prescription for tetracycline (Doxycycline) orally each day. The client reported current medications include a multivitamin with calcium, St. John's Wort, and omeprazole (Prilosec). The nurse would provide additional teaching for which client statement? A) "I should try to take the medication at roughly the same time each day." B) "I can take this medication with my other morning meds." C) "I should take this medication at least an hour before or 2 hours after I eat." D) "Drinking extra water is important when taking this medication."

B) "I can take this medication with my other morning meds."

While working in an urgent care center, the nurse assists in the care of a client with allergic rhinitis who has been given a prescription for beclomethasone nasal spray (Beconase), 2 sprays in each nostril 2 to 4 times daily. The nurse would provide further instruction to which of the following client statements? A) "This will help my nose to not run so constantly." B) "I should spray this in each nostril whenever my nose starts to drip." C) "I can use this before I go to work, midday, and again at bedtime." D) "This medication is a mild steroid and will reduce swelling and irritation of my nasal passages."

B) "I should spray this in each nostril whenever my nose starts to drip."

A woman experiencing menopausal symptoms asks the nurse about conjugated estrogen (Premarin). Which of the following statements by the individual indicates an understanding of the medication's origin? A) "I'm against animal cruelty, so I don't want to take anything made from animal flesh." B) "I was told the medication is actually derived from the urine of pregnant horses." C) "Because I'm Jewish, I can't take the medication since it comes from pigs." D) "I think harvesting medicines from cows seems rather odd."

B) "I was told the medication is actually derived from the urine of pregnant horses."

While preparing a client with diabetes for discharge, the nurse recognizes teaching has been effective by which of the following statements? A) "I will recap the needles before discarding them into the trash can." B) "I will rotate sites along my thighs and across my abdomen." C) "I will pull the skin taunt before injecting the needle." D) "I will insert the needle at a 30-degree angle."

B) "I will rotate sites along my thighs and across my abdomen."

The nurse is preparing to provide evening medications. It is currently 8 p.m. The nurse will pass medications scheduled at which military time? A) 1600 B) 1800 C) 2000 D) 2200

C) 2000

A nurse working in the GI clinic is performing pre-op phone calls. The nurse calls a client who is scheduled for a colonoscopy to inform the client of the following orders, "Begin clear liquid diet 24 hours prior to the exam; take magnesium citrate (Citroma) 1 bottle PO 12 hours prior to the exam and another 8 hours prior to the exam; remain NPO for 6 hours prior to the study." The test is scheduled the next day at 2 p.m. The nurse would instruct the patient to: A) "Only have liquids to drink at this point until the test. Use the enema prep at 2 a.m. and then again at 6 a.m. You can't have anything to eat or drink after waking in the morning." B) "Start a clear liquid diet today at 2 p.m. Drink a bottle of prep at 2 a.m. and another at 6 a.m., and then don't eat or drink anything after 8 a.m." C) "Don't eat anything solid starting with lunch today. Give yourself an enema with the prep at 6 a.m. and again at noon, and don't have anything to eat or drink after 8 a.m." D) "Start a clear liquid diet with dinner today. Drink the prep 12 hours and 8 hours before your test at 2 p.m. tomorrow, and be sure not to eat anything solid after you get up in the morning."

B) "Start a clear liquid diet today at 2 p.m. Drink a bottle of prep at 2 a.m. and another at 6 a.m., and then don't eat or drink anything after 8 a.m."

A student nurse asks a friend in the program, "What does it mean when a medication is buffered?" Which response by the friend is best? A) "Buffered medications have been dissolved in oils or fats." B) "That means the medication has added antacids to reduce stomach upset." C) "Buffering extends the metabolism of the drug so it stays in the system longer." D) "You can't crush a tablet if it is buffered because it has a special coating."

B) "That means the medication has added antacids to reduce stomach upset."

The nurse provides a client with 20 mL of megestrol acetate (Megace 40 mg/mL strength) and the client reports, "I usually take one teaspoon of the long-acting formulation; are you sure this is the right stuff?" The nurse checks with the pharmacy and learns 5 mL of megestrol extended release (Megace ES 125 mg/mL) is equivalent to 800 mg of Megace. Which response by the nurse is best? A) "You are right; you should only take 5 mL of this medication." B) "The two doses are equal since we don't carry the long-acting medication." C) "You should be taking 20 mL of medication at home as well." D) "We will hold the medication at this time and verify the order with the physician."

B) "The two doses are equal since we don't carry the long-acting medication."

The nurse is applying hydrocortisone cream to a client's rash. Which statement would be included in the nurse's instructions to the client? A) "This medication increases blood flow to the skin and helps reduce pain." B) "This will be absorbed through the skin to help reduce the itch." C) "Since this is water-based it may leave a greasy feeling to your skin." D) "Be sure to shake this well and apply it with a cotton ball."

B) "This will be absorbed through the skin to help reduce the itch."

A client with a compressed disc in the lumbar region takes Vicodin every 6 hours for pain control. He tells the nurse, "This pain medication just doesn't seem to be working anymore." Which response by the nurse is best? A) "Are you taking the medication with a full glass of water?" B) "You may be developing a tolerance to the medication." C) "We will have to draw some lab work to see if your stomach is digesting the medication correctly." D) "How did you rank your pain on a 0-10 scale with your original injury?"

B) "You may be developing a tolerance to the medication."

The student nurse is preparing to give a client 20 mEq of potassium chloride (K-LOR). Directions say to mix the powdered medication with at least 4 oz of juice or water. The instructor would be satisfied with the student's preparation if the student had which of the following? A) 80 mL of apple juice B) 120 mL of grape juice C) 2/3 cup of water D) 1 cup of fruit punch

B) 120 mL of grape juice

While working on a geriatric unit, the nurse would be most concerned by which of these findings? A) An 81-year-old client is scheduled to take 12 pills at 9 a.m. B) A 72-year-old client given a sleeping pill the night before seems confused. C) A 69-year-old client with a deep vein thrombosis has an order for an anticoagulant. D) A 74-year-old client with diabetes has a fasting glucose result of 88 g/dL.

B) A 72-year-old client given a sleeping pill the night before seems confused.

The nurse is providing care for clients on the orthopedic unit. Which of the following assessment findings is most concerning to the nurse? A) A client who takes lisinopril (Zestril) and is complaining of limited range of motion after shoulder surgery B) A client with a fractured pelvis who takes warfarin sodium (Coumadin) and reports having a black tarry stool during the night C) A client 2 days post-op for knee replacement who takes hydrocodone/acetaminophen (Vicodin) and refused to have labs drawn this morning D) A client 4 days after hip replacement surgery taking omeprazole (Prilosec) who ordered spinach for dinner

B) A client with a fractured pelvis who takes warfarin sodium (Coumadin) and reports having a black tarry stool during the night

The nurse notes orders for lorazepam (Ativan) 1 mg PO qhs prn. Which action by the nurse is best? A) Give the client 1 mg at noon each day. B) Ask the client at bedtime if he/she would like to take an Ativan. C) Schedule the Ativan daily with breakfast. D) Instruct the client to ask for Ativan any time it is needed.

B) Ask the client at bedtime if he/she would like to take an Ativan.

While working with the parents of a child newly diagnosed with cystic fibrosis, the nurse prepares to teach them how to use which type of equipment? A) Syringe and subcutaneous needle B) Nebulizer C) Nasal dropper D) Nasogastric suction

B) Nebulizer

While caring for a client who is taking furosemide (Lasix), the nurse recognizes dietary teaching has been effective if the patient includes which of the following foods in his daily menus? A) Broccoli and kiwi B) Oranges and sweet potatoes C) Kale and cucumbers D) Bananas and melon

B) Oranges and sweet potatoes

The nurse is preparing to provide medications to a client in a double room. The client's roommate has multiple visitors present. Which of the following actions would the nurse take first? A) Identify the action and side effect of each medication as it is provided. B) Pull the client's bedside curtain and talk in subdued tones. C) Ask the client to state his name and birth date to verify identity. D) Determine what questions the client has about his medications.

B) Pull the client's bedside curtain and talk in subdued tones.

The nurse is conducting a home visit for a 43-year-old client. The client, who has three children under the age of 12, is 3 days post-mastectomy. The nurse would be most concerned by which of the following? A) The client has a calendar for appointments and a list with physician contact information by the phone. B) The client keeps her medications in a daily pill box that sits on the kitchen windowsill. C) The client reports that it was too uncomfortable to wear the temporary prosthesis she had been given. D) The children are participating in a support group for family members of people with cancer.

B) The client keeps her medications in a daily pill box that sits on the kitchen windowsill.

The nurse is providing care for a 48-year-old male on the surgical unit. Gentamicin (Garamycin) 2 mg/kg every 8 hours has been started. The nurse would be most concerned by which of the following findings? A) Blood levels have been ordered every 24 hours B) The patient's EGFR = 40 mL/min C) The patient's hemoglobin = 11.8 g/dL D) The patient's WBC = 14,000 c/mm3

B) The patient's EGFR = 40 mL/min

The student is asked to demonstrate the Z-track method of IM injection in a lab model. Which action would cause the instructor to intervene? A) Student preps the dorsogluteal site. B) The student pulls the skin laterally 1/2 inch from the injection site. C) The student uses a dart-like motion for needle insertion. D) The student waits 10 seconds before removing the needle.

B) The student pulls the skin laterally 1/2 inch from the injection site.

A client newly diagnosed with diabetes tells the nurse, "I can't take any insulin made from pigs or cows." Which of the following responses by the nurse is best? A) "Most insulin comes from animal sources, but I'm sure alternative options are available." B) "Medications that are derived from animals are typically less expensive than synthetic medications, but synthetic insulin is commonly available." C) "Most insulin is synthetic now to help reduce the risk of disease transmission." D) "The animals aren't hurt in the production of medications, so you don't need to worry."

C) "Most insulin is synthetic now to help reduce the risk of disease transmission."

The nurse is preparing to discharge a client originally admitted for community-acquired pneumonia who has a discharge prescription for cefditoren (Spectracef). Which of the following instructions would the nurse include in the discharge teaching? A) "Be sure to take the medication until your cough is gone." B) "It is important that you take the medication with meals." C) "Taking the medication at set time intervals will help blood levels stay constant." D) "Keeping the medication on the counter top will help you remember to take it."

C) "Taking the medication at set time intervals will help blood levels stay constant."

The nurse is receiving a shift-to-shift report on a medical unit and is informed that a 55-year-old patient with a history of vomiting is scheduled for a diagnostic radiograph of the upper gastrointestinal tract. Which of the following statements would the nurse include in the client's teaching? A) "You will need to drink a large amount of prep to clear out your system before the test." B) "It is important that you be given a prophylactic medication to prevent aspiration during the test." C) "You will be asked to drink a barium contrast about 30 minutes before the test to help highlight any digestive problems." D) "You will be given a sedative to help make you sleepy during the testing procedure."

C) "You will be asked to drink a barium contrast about 30 minutes before the test to help highlight any digestive problems."

The nurse is providing care for a client who is taking dulasteride (Avodart) for benign prostatic hypertrophy (BPH). The client's prescription reads, "Take daily by mouth." Thirty pills have been dispensed and the prescription allows for five refills. The nurse anticipates seeing the client again in: A) 1 month B) 3 months C) 6 months D) 1 year

C) 6 months

A client with Alzheimer's disease is started on donepezil (Aricept) 10 mg PO qhs. The nurse will administer this medication at: A) 6 p.m. B) 6 a.m. C) 9 p.m. D) 9 a.m.

C) 9 p.m.

The student nurse is preparing to provide a flu vaccine to an 18-year-old client. The medication is provided by pharmacy in a vial containing 0.5 ml of medication. Which syringe should the student select? A) A 100-unit insulin syringe B) A 5-ml standard syringe C) A 3-ml hypodermic syringe D) A 1-ml tuberculin syringe

C) A 3-ml hypodermic syringe

While monitoring a client receiving chemotherapy set to infuse over 3 hours, the nurse notes after the first hour that just over 160 mL of the original 500 mL has infused. Which action by the nurse is best? A) Alter the pump setting to infuse at 150 mL/hr. B) Alter the pump setting to infuse at 200 mL/hr to ensure the medication finishes on time. C) Assure the client the infusion is running appropriately and document current assessment. D) Instruct the client the infusion will be completed in another 2.5 hours and do not change the infusion rate.

C) Assure the client the infusion is running appropriately and document current assessment.

While caring for a client being sent home with a prescription for oxycodone and acetaminophen (Percocet), the nurse must caution the client to avoid which of the following? A) Eye drops or medications causing pupil constriction B) Alcoholic beverages and grapefruit juice C) Cold remedies and other products containing Tylenol D) Fiber laxatives and other stool softeners

C) Cold remedies and other products containing Tylenol

While working in a surgical clinic, the nurse notes orders that read, ".25 mg digoxin (Lanoxin) IV now." Which action by the nurse is best? A) Give .25 mg of digoxin intravenously. B) Give 25 mg of digoxin as an injection into the skin. C) Contact the physician for clarification of the order. D) Give .25 mL of digoxin as an intramuscular injection.

C) Contact the physician for clarification of the order.

A nurse finds a bottle of cough medicine elixir opened on the bathroom sink and realizes it was left there in the middle of the night when the nurse's spouse was up. What action by the nurse is best? A) Determine how much elixir was taken. B) Recap the bottle of medication and place it back in the medicine cabinet. C) Discard any remaining medication. D) Insist the spouse be more responsible in the future.

C) Discard any remaining medication.

The nurse is preparing to apply valacyclovir (Valtrex) ointment to the shingles lesions located across a client's left side and lower back. Which of the following actions should the nurse take first? A) Place the patient in a supine position. B) Determine when the rash was first noted. C) Ensure that the skin is clean and dry. D) Take the patient's vital signs.

C) Ensure that the skin is clean and dry.

Which action by the nurse will help reduce the risk of air emboli for a client receiving intravenous therapy? A) Maintain sterility when spiking a new IV bag. B) Use the flow regulator to adjust the rate of the IV fluid. C) Make sure all tubing and ports are sufficiently filled when priming the tubing. D) Wear gloves when starting the IV site.

C) Make sure all tubing and ports are sufficiently filled when priming the tubing.

Nurses are protected from unnecessary job-related risks due to the regulations set by: A) Food and Drug Administration (FDA) B) Drug Enforcement Administration (DEA) C) Occupational Safety and Health Administration (OSHA) D) Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

C) Occupational Safety and Health Administration (OSHA)

The nurse must shake which of the following prior to provision? A) Emulsion B) Elixir C) Suspension D) Solution

C) Suspension

The instructor is supervising medication administration in a home setting. Which action would require an intervention? A) The student wears gloves to remove a Nicoderm patch. B) The student removes a patch from the left arm and places a new patch on the right arm. C) The student folds the old patch in half and discards it in the trash can. D) The student places the patch on an area of skin that has minimal hair.

C) The student folds the old patch in half and discards it in the trash can.

A nurse from the adult medical unit is pulled to the geriatric unit. The nurse notes many of the common medications provided are in lower doses than typically prescribed. What action by the nurse is the highest priority? A) Notify the charge nurse that clients may have received inappropriate medication dosages. B) Call the nursing supervisor to investigate the nurse's concerns. C) Don't worry about the discrepancy since this is not the nurse's unit. D) Evaluate the lab values of each client to determine liver and kidney function.

D) Evaluate the lab values of each client to determine liver and kidney function.

A client with advanced colorectal cancer is going to start taking long-acting morphine sulfate (MS Contin). Which of the following statements by the nurse is best? A) "I will call the prescription into your local pharmacy." B) "You are only allowed to have one refill on this medication before you have to see the doctor again." C) "This is considered a Schedule IV medication, so there are strict guidelines we must follow." D) "I am faxing the prescription to the pharmacy, but you must also take this written prescription with you to pick it up."

D) "I am faxing the prescription to the pharmacy, but you must also take this written prescription with you to pick it up."

The nurse is working with a client who was recently started on insulin therapy. The client's young daughter asks, "Why do you have to give her a shot? Why can't you just give her a pill?" Which of the following responses by the nurse is best? A) "Our bodies make insulin normally, so it is a liquid medication." B) "We do have diabetic medications in pill form. I'm not sure why the doctor ordered it this way for your mom." C) "Insulin is manufactured and given this way so it absorbs more rapidly into the body." D) "The acid in your mother's stomach would destroy this medication, so it can't be swallowed."

D) "The acid in your mother's stomach would destroy this medication, so it can't be swallowed."

The nurse provides teaching for the mother of a 10-year-old patient who will begin taking Adderall XR. Which statement would the nurse include in the teaching? A) "Your child will need to take this medication at even intervals throughout the day." B) "This medication is very helpful for children who have problems with bed wetting." C) "If your child has trouble with pills, you can crush this and add it to pudding." D) "This medication is designed to be released into the bloodstream all day long."

D) "This medication is designed to be released into the bloodstream all day long."

The nurse receives a phone call from an elderly woman who states that her husband has recently started taking atorvastatin (Lipitor) and is complaining of having sore muscles. Which response by the nurse is best? A) "Does your husband smoke cigarettes?" B) "What type of exercise is your husband doing?" C) "Does your husband have a history of heart disease?" D) "Your husband should be seen in the clinic today for some tests."

D) "Your husband should be seen in the clinic today for some tests."

The nurse is caring for a client with early symptoms of shock. The physician has ordered a unit of blood. The nurse will hang this using Y-tubing and which solution? A) D5W B) Lactated ringers C) D5/0.45NS D) 0.9% NS

D) 0.9% NS

Which of the following clients is most likely to benefit from a CPAP machine? A) A 52-year-old client with asthma B) An 84-year-old client with chronic obstructive pulmonary disease (COPD) C) A 66-year-old client with chronic bronchitis D) A 48-year-old client with obstructive sleep apnea

D) A 48-year-old client with obstructive sleep apnea

While providing medications to clients on the cardiac unit, the nurse anticipates that hydralazine hydrochloride and isosorbide dinitrate (BiDil) would most likely be prescribed for which of the following clients? A) A 48-year-old Caucasian male diagnosed with atrial fibrillation B) A 55-year-old African American female diagnosed with hypertension C) A 63-year-old Caucasian female diagnosed with sick sinus syndrome D) A 64-year-old African American male diagnosed with heart failure

D) A 64-year-old African American male diagnosed with heart failure

A nurse on the pediatric unit is preparing to pass medications for a 10-year-old client with exacerbation of asthma. Amphetamine (Adderall) and fluticasone (Advair) are scheduled. The nurse must be aware of which of the following? A) Adderall and Advair should not be given at the same time. B) Adderall is used to reduce bronchospasms. C) Advair must be given with food. D) Adderall and Advair each have look-alike/sound-alike medications.

D) Adderall and Advair each have look-alike/sound-alike medications.

The nurse notes, "Antifungal troches to buccal mucosa TID" as a new client order. The nurse explains to the client that this medication will be delivered: A) As a capsule inserted rectally B) As a liquid under the tongue C) As a pill to be swallowed D) As a lozenge to be held in the cheek

D) As a lozenge to be held in the cheek

While preparing to provide a patient admitted to the hospital for a laparoscopic hysterectomy the prescribed dose of ibuprofen (Motrin) 800 mg orally, which of the following actions would take highest priority? A) Determine if the client has eaten within the past hour. B) Assess the client's vaginal discharge. C) Help the client ambulate in the hall. D) Evaluate the client's most recent renal panel labs.

D) Evaluate the client's most recent renal panel labs.

The nurse notes that an elderly client admitted with metastatic cancer has a low serum protein level. Which action by the nurse is best? A) No action is required because the patient is terminal. B) Increase the frequency of vital sign monitoring. C) Determine the most recent complete blood count (CBC) results. D) Increase awareness and assessment of potential medication side effects.

D) Increase awareness and assessment of potential medication side effects.

A student nurse is providing care for a 29-year-old patient with advanced cervical cancer who was recently admitted with metastatic disease. While reviewing the patient's medication list, the student would categorize which of the following medications as palliative in nature? A) Cisplatin (Platinol) 50 mg IV weekly to start day 8 B) Sorafenib (Nexavar) 200 mg orally twice daily for 7 days C) Ondansetron (Zofran) 4 mg IV prior to chemotherapy D) Morphine sulfate (Roxanol) 5 mg po every 4 hours as needed for pain

D) Morphine sulfate (Roxanol) 5 mg po every 4 hours as needed for pain

The student nurse is preparing to provide medications to a client scheduled to receive lisinopril (Zestril) 10 mg PO daily and ofloxacin (Floxin) 2 drops o.s. three times daily. Which of the following actions by the student is best? A) Provide the lisinopril by mouth and the ofloxacin into the right ear. B) Provide the lisinopril into the right ear and the ofloxacin into the right eye. C) Provide the lisinopril into the left ear and the ofloxacin orally. D) Provide the lisinopril orally and the ofloxacin into the left eye.

D) Provide the lisinopril orally and the ofloxacin into the left eye.

A nurse working at the health clinic is administering tuberculosis tests. The test is will need to be repeated if which of the following is noted? A) A wheal is seen at the site of injection. B) The needle is inserted at a 15-degree angle. C) The nurse notes a tiny amount of blood when removing the needle. D) Some of the medication leaks after completion of the injection.

D) Some of the medication leaks after completion of the injection.

The nurse working in a diagnostic center is responsible for verifying client allergies prior to testing. A 47-year-old woman reports being allergic to iodine, and thus is unable to have which test? A) Computerized axial tomography (CAT) scan B) Magnetic resonance imaging (MRI) C) Colonoscopy D) Thyroid scan

D) Thyroid scan

The following order is written for a 28-year-old client with asthma, "Budesonide nasal (Pulmicort) 2 sprays each nostril bid." The nurse will instruct the client to take this medication: A) Once daily with two sprays in each nostril B) Once each evening with one spray in each nostril C) One spray in each nostril twice daily D) Two sprays in each nostril two times each day

D) Two sprays in each nostril two times each day