Pharmacology Practice Questions
A nurse is providing teaching to a client who has heart failure and is taking spironolactone. Which of the following statements by the client indicates an understanding of the teaching? A. "I will increase my intake of citrus fruits, bananas, and potatoes." B. "I will use salt substitutes on my food." C. "I will drink as much water as I can while taking this medication." D. "I will watch for increased breast tissue growth while taking this medication."
Correct Answer: D. "I will watch for increased breast tissue growth while taking this medication." Spironolactone, which is derived from steroids, can cause adverse endocrine effects such as gynecomastia, impotence in men, and irregular menses and hirsutism in women. The nurse should instruct the client that these changes can occur. Incorrect Answers: A. Spironolactone is a potassium-sparing diuretic. Clients taking potassium-sparing diuretics should limit their intake of foods high in potassium due to the risk of hyperkalemia. B. Clients who are taking potassium-sparing diuretics should not use salt substitutes because they contain potassium and place the client at risk for hyperkalemia. C. Drinking large amounts of water can cause dilutional hyponatremia, which is dangerous when taking spironolactone since electrolyte imbalances, including hyponatremia, are common.
The nurse is caring for a client who has had a levonorgestrel-releasing intrauterine device (IUD) in place for 1 year. Which of the following findings should indicate that the client is experiencing an adverse effect? A. Developed sensitivity to copper B. Vaginal irritation or inflammation C. Decreased menstrual bleeding D. Spotting between menses cycles
Correct Answer: D. Spotting between menses cycles Light spotting and amenorrhea are common adverse effects for clients who use a levonorgestrel-releasing IUD. IUDs can alter menses, prompting spotting between menstruation periods. Incorrect Answers:A. The levonorgestrel-releasing intrauterine device IUD is made of plastic and does not contain copper. However, other IUDs do contain copper. B. Vaginitis is a common adverse effect of a vaginal contraceptive ring but not of an IUD. IUDs can produce a localized inflammatory response in the uterus, but this reaction is harmless unless the client develops a pelvic inflammatory infection. C. This type of IUD releases levonorgestrel, which generally reduces menstrual bleeding over time and decreases menorrhagia in clients who use an IUD for contraception. A decrease in menstrual bleeding is not an adverse effect of the device.
A nurse is teaching to a client who has systemic lupus erythematosus about a new prescription for oral glucocorticoid therapy. Which of the following client statements indicates an understanding of the teaching? A. "I should take a calcium supplement while on this medication." B. "Regular liver function studies will have to be done while I am taking this medication." C. "I can take NSAIDs to treat mild pain while using this medication." D. "I will be sure to eat 6 small meals a day to prevent hypoglycemia from this medication."
Correct Answer: A. "I should take a calcium supplement while on this medication." An adverse effect of systemic glucocorticoid therapy is osteoporosis. Increasing calcium-rich foods in the diet and adding calcium and vitamin D supplements should be encouraged to prevent osteoporosis and decrease the risk of fractures. Incorrect Answers:B. Glucocorticoids do not affect liver function. Other medications like HMG-CoA reductase inhibitors or statins require periodic liver function tests. C. NSAIDs should be avoided while undergoing systemic glucocorticoid therapy due to the increased risk of gastric ulceration. Combining these medications increases the risk of gastrointestinal bleeding. The client should be instructed to check for gastrointestinal bleeding and report black, tarry stools to the provider. D. The nurse should instruct the client that hyperglycemia is a side effect of oral glucocorticoid therapy.
A nurse is caring for a client who has asthma and a prescription for zileuton. Which of the following laboratory values should the nurse monitor while the client is taking this medication? A. Alanine aminotransferase (ALT) B. WBC count C. Potassium D. Chloride
Correct Answer: A. Alanine aminotransferase (ALT) The nurse should identify that ALT is a liver function test. Zileuton is a leukotriene modifier that can affect the liver, causing increased ALT levels. The nurse should monitor this laboratory value closely while the client is taking the medication. Incorrect Answers:B. A WBC count that is outside of the expected reference range can indicate a blood disorder or infection. However, this laboratory value is not associated with a potential adverse reaction to this medication. C. Potassium levels that are outside of the expected reference range can be associated with acute or chronic condition of the heart, kidneys, nerve, or muscle cells. However, potassium levels that are outside of the expected reference range are not associated with a potential adverse reaction to this medication. D. Chloride levels that are outside of the expected reference range can occur as a result of an acid-base or electrolyte imbalance. However, chloride levels that are outside of the expected reference range are not associated with a potential adverse reaction to this medication.
A nurse is caring for a client who has asthma and advanced rheumatoid arthritis and deformity of the hands. The nurse should anticipate that the client will receive which of the following medication-delivery devices for the treatment of asthma? A. Dry-powder inhaler (DPI) B. Metered-dose inhaler (MDI) with spacer C. Respimat D. Nebulizer
Correct Answer: A. Dry-powder inhaler (DPI) The nurse should identify that DPIs do not require hand-breath coordination and are easier to use for clients who have deformities of the hands. DPIs are used to deliver medications in a dry, micronized powder directly to the lungs. Incorrect Answers:B. MDIs with spacer devices require hand-breath coordination in order to ensure maximum deposition of medication. This can be more difficult for a client who has deformity of the hands. C. Respimat inhalers deliver medication as a fine mist. Although these devices do not require as much hand-breath coordination as MDIs, they still require the client to activate the device using a twisting motion, which can be more difficult for a client who has deformity of the hands. D. Nebulizers are small machines that convert liquid medication into a fine mist for inhalation. The medications used with nebulizers often require twisting of small ampules to open, which can be more difficult for a client who has deformity of the hands.
A nurse is preparing to administer the varicella vaccine to a 12-month-old infant. The nurse asks the infant's guardian if the infant has any allergies. Which of the following allergies is a contraindication to the infant receiving the vaccine? A. Gelatin B. Milk C. Eggs D. Peanuts
Correct Answer: A. Gelatin An allergy to gelatin is a contraindication to receiving the varicella vaccine; therefore, the nurse should contact the infant's provider. Incorrect Answers:B. An infant who has a milk allergy can receive the varicella vaccine. C. An egg allergy is a contraindication to receiving the influenza vaccine, and the client's parent should consult the provider. An infant who has an egg allergy can receive the varicella vaccine. D. An infant who has a peanut allergy can receive the varicella vaccine.
A nurse is teaching a client about the proper placement of a nitroglycerin patch. Which of the following statements by the client indicates an understanding of the teaching? A. "I'll apply the patch over areas of my body with little fatty tissue." B. "I can place the patch on any area of my body without hair." C. "I'll put the patch on the same site as the previous patch." D. "I have to apply the patch directly over my heart."
Correct Answer: B. "I can place the patch on any area of my body without hair." The nitroglycerin transdermal patch should be applied to skin that is free from hair because hair creates a physical barrier to absorption. Incorrect Answers:C. Placing the nitroglycerin patch on the same site as a previous patch should be avoided because it can cause skin irritation. D. The nitroglycerin patch does not have to be applied directly over the heart. Various topical locations are acceptable.
A nurse is teaching a client who has a new prescription for amitriptyline to treat depression. Which of the following client statements indicates an understanding of the teaching? A. "I should take this medication when I experience active symptoms." B. "I should take this medication before bedtime." C. "This medication may cause excess salivation." D. "I might experience weight loss while taking this medication
Correct Answer: B. "I should take this medication before bedtime." The nurse should instruct the client that an adverse effect of amitriptyline is sedation. The nurse should instruct the client to take the medication at bedtime to minimize sedation during waking hours while promoting sleep. Incorrect Answers:A. The nurse should instruct the client about taking this medication daily as prescribed. The nurse should warn the client not to discontinue this medication abruptly once mood has improved. C. The nurse should instruct the client that this medication has anticholinergic effects such as dry mouth, blurred vision, urinary retention, and constipation. D. The nurse should instruct the client that an adverse effect of amitriptyline is weight gain. The nurse should encourage the client to monitor weight routinely during treatment.
A nurse is administering a client's first dose of sucralfate. Which of the following explanations should the nurse provide about the action of sucralfate? A. "Sucralfate decreases gastric acid secretions." B. "Sucralfate forms a gel-like substance that protects ulcers." C. "Sucralfate inactivates Helicobacter pylori." D. "Sucralfate inhibits the production of gastric acid."
Correct Answer: B. "Sucralfate forms a gel-like substance that protects ulcers." The primary action of sucralfate is the formation of a gel-like protectant that adheres to the ulcer surface. This protective mechanism lasts for 6 hours and allows the ulcer to heal. Incorrect Answers:C. Sucralfate does not inactivate H. pylori. Management of H. pylori requires an antibiotic regimen of 2 or 3 medications like clarithromycin, amoxicillin, tetracycline, and metronidazole. The regimen should last 10 to 14 days and should also include a proton pump inhibitor (PPI) or a histamine-2 receptor antagonist (H2RA). D. Sucralfate does not inhibit the production of gastric acid. Proton pump inhibitors (PPIs) like omeprazole block the enzyme that initiates the production of gastric acid. Suppression of gastric acid production is effective in treating gastric and duodenal ulcers and GERD.
A nurse is teaching an assistive personnel (AP) about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's selection of which of the following foods for the client's lunch indicates an understanding of the teaching? A. Bologna on wheat bread B. Chicken salad C. Cheddar cheese and crackers D. Pizza with pepperoni
Correct Answer: B. Chicken salad Phenelzine is an MAOI. Clients taking MAOIs must avoid foods that contain tyramine due to the potential for a dangerous food-drug interaction. Foods high in tyramine include those that are processed and aged, such as luncheon meats and cheeses. This menu selection does not contain food high in tyramine and indicates an understanding of the teaching. Incorrect Answers: A. This menu selection includes a highly processed meat that contains tyramine; therefore, it is not an appropriate choice. C. This menu selection includes an aged cheese that contains tyramine; therefore, it is not an appropriate choice. D. This menu selection includes pizza, which typically includes aged cheese (such as parmesan) and processed meat, both of which contain tyramine; therefore, it is not an appropriate choice.
A nurse is caring for a client who has atrial fibrillation and is scheduled for cardioversion. The nurse should anticipate a prescription from the provider for which of the following medications for this procedure? A. Amlodipine B. Diltiazem C. Nifedipine D. Lidocaine
Correct Answer: B. Diltiazem The nurse should anticipate a prescription for diltiazem, which blocks calcium channels in the heart and blood vessels, thereby lowering blood pressure. Also, it is an antiarrhythmic medication that is used during cardioversion to treat atrial fibrillation. Incorrect Answers:A. Amlodipine is a calcium channel blocker. However, it minimally blocks calcium channels in the heart and is not used to treat arrhythmias. Amlodipine is used to treat hypertension or angina pectoris. C. Nifedipine is a calcium channel blocker that minimally blocks calcium channels in the heart and is not used to treat arrhythmias. It is indicated for hypertension or angina pectoris. D. Lidocaine is an antidysrhythmic medication used to treat ventricular dysrhythmias.
A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should highlight that which of the following conditions is a contraindication to this medication? A. Hyperthyroidism B. Intestinal obstruction C. Glaucoma D. Low blood pressure
Correct Answer: B. Intestinal obstruction Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation. Incorrect Answers:A. Metoclopramide can be administered to a client who has hyperthyroidism. C. Metoclopramide can be administered to a client who has glaucoma. D. Metoclopramide can be administered to a client who has hypotension. It should be used with caution for a client who has hypertension.
A nurse is reinforcing teaching with a newly licensed nurse about contraindications to vaccines. Which of the following examples should the nurse provide as a true contraindication for all vaccines? A. Previous local reaction to an injectable vaccine B. Moderate illness without a fever C. Recent exposure to an infectious disease D. Family history of an allergy to penicillin
Correct Answer: B. Moderate illness without a fever The nurse should identify that a client who has a moderate or severe illness with or without a fever has a true contraindication to receiving a vaccine. The nurse should postpone the immunization until the client has recovered from the illness. Incorrect Answers:A. A mild local reaction such as soreness, erythema, or swelling following a dose of an injectable vaccine is not a contraindication to receiving an immunization. The nurse can still administer subsequent immunizations. C. Recent exposure to an infectious disease is not a contraindication to receiving a vaccine. The nurse can still administer subsequent immunizations. D. A family history of allergy to penicillin is not a contraindication to receiving a vaccine. The nurse can still administer subsequent immunizations.
A nurse is teaching a client who has been taking an NSAID to treat rheumatoid arthritis. During the client's first month checkup, the provider prescribed methotrexate to be added to the medication regimen. Which of the following statements should the nurse include in the teaching about the purpose of this change in the client's medication? A. "Your current medication was not strong enough to manage this condition." B. "Once your blood levels of methotrexate are within the therapeutic range, the NSAID will be discontinued." C. "This medication was added to delay the disease progression." D. "Treating this disease with 2 medications will help protect you from becoming treatment-resistant."
Correct Answer: C. "This medication was added to delay the disease progression." The nurse should inform the client that the provider prescribed methotrexate to be added to the medication regimen along with an NSAID to delay the progression of the disease and to delay joint damage or deformity that can result from the disease. Incorrect Answers:A. When a mediation is no longer effective, the dosage is increased, or the medication is discontinued. B. Methotrexate does not have to reach a therapeutic range in the client's blood to be effective. However, it is the fastest acting medication in its class and has a therapeutic effect at 3 to 6 weeks. D. Rheumatoid arthritis is not a disease in which treatment resistance is a concern.
