Pharmacology quiz 40 questions

A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching?

"I will give my child a dose as soon as wheezing starts." *Cromolyn is a mast cell inhibitor that has a slow onset and is given for prophylactic treatment of asthma. It is not a rescue medication.

A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply.)

-PTT -Aspartate aminotransferase (AST) -Alanine aminotransferase (ALT) *Valproic acid an alfter coagulation; therefore, PT and PTT should be monitored. *Valproic acid can cause life-threatening hepatoxicity. The client should have baseline liver function tests (LFTs) before starting this medication and LFTs should be repeated at regular intervals during therapy. *ALT is a liver enzyme that is measured as a component of liver function tests. Levels of the enzyme identify liver damage.

A nurse is providing teaching to a client who has gout and a new prescription for allopuinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects?

Fever *Fever can indicate a potentially fatal hypersensitivity reaction. The client should discontinue the allopurinol and notify the provider if a fever or rash develops.

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects?

Fever *Fever can indicate a potentially fatal hypersensitivity reaction. The client should discontinue the allopurinol and notify the provider if a fever or rash develops.

A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?

Hypotension *Enalapril, an angiotension-converting enzyme (ACE) inhibitor, can cause hypotension and postural hypotension, especially during the first 3 hours following the initial dosage.

A nurse is assessing a client who is receiving IV gentamicin three times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?

Proteinuria *Proteinuria is a manifestation of nephrotoxicity, an adverse effect of gentamicin. The nurse should monitor for oliguria and hematuria.

A nurse is providing teaching to a client who has a urinary tract infection and new prescription for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching?

"I should notify my provider immediately if my urine turns an orange color." *Phenazopyridine is a urinary tract analgesic used to relieve pain and burning during urination. The medication can cause the client's urine to turn a reddish-orange color. This coloration is an expected effect of this medication, although it can stain clothing and does not need to be reported to the provider.

A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

"Rifampin can turn body fluids orange." *Rifampin can cause body fluids, such as tears, sweat, saliva, and urine, to turn a reddish-orange color. The nurse should inform the client that this effect does not cause harm.

A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer?

Acetaminophen *Acetaminophen is an analgesic used for mild to moderate pain. It can be administered to a client who has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of gastrointestinal bleeding.

A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects?

Bleeding *Clopidogrel is an antithrombotic medication that inhibits platelet aggregation. It is used to prevent stenosis of coronary stents, myocardial infarctions, and strokes. The nurse should monitor for coffee ground emesis, black tarry stools, ecchymosis, or any indication of bleeding.

A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects?

Dizziness *Zolpidem can cause dizziness and daytime drowsiness. It can cause confusion in the older adult client.

A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications?

Levothyroxine *Levothyroxine replaces thyroid hormone for a client who has hypothyroidism. Laboratory values for hypothyroidism include an increased TSH level and decreased total T3 and T4 levels. Clinical manifestations for hypothyroidism include fatigue, cold intolerance, and a decreased body temperature and pulse.

A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?

Liver function *Gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. It can cause liver toxicity; therefore, the nurse should monitor the client's liver function.

A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects?

Muscle weakness *Chlorothiazide is a thiazide diuretic used to treat hypertension and congestive heart failure. It promotes excretion of water, sodium, and potassium, and can cause hypokalemia. Manifestations of hypokalemia include muscle weakness, muscle cramps, and dysrhythmias.

A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications as a contraindication to ceftriaxone?

Piperacillin *Clients who have a severe allergy to piperacillin, which is a penicillin, can have a cross sensitivity to ceftriaxone, a third-generation cephalosporin. Ceftriaxone is contraindicated for the client who has an allergy to cephalosporins or a severe allergy to penicillin.

A nurse is providing teaching to a client who has chronic kidney failure with AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching?

Promotes RBC production *Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common in clients who have chronic kidney failure, since erythropoietin is produced by the kidney.

A nurse is reviewing the laboratory values for a client who is receiving a continuous IV heparin and has an aPTT of 90 seconds. Which of the following actions should the nurse prepare to take?

Reduce the infusion rate *An aPTT of 90 seconds is outside the expected reference range of 60 to 80 seconds, which can cause anticoagulation. The nurse should contact the provider reduce the infusion rate, and assess the client for bleeding.

A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

"Take the hydrochlorothiazide in the morning." *The client should take hydrochlorothiazide in the morning to allow for diuresis during the day and prevent nocturia.

A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

0.5 mL *Dimensional Analysis Step 1: What is the unit of measurement the nurse should calculate? mL Step 2: What is the quantity of the dose available? 1 mL Step 3: What is the dose available? Dose available = Have 5 mg Step 4: What is the dose the nurse should administer? Dose to administer = Desired 2.5 mg Step 5: Should the nurse convert the units of measurement? No Step 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion(Desired) x Desired/ X mL = 1 mL/5 mg x 2.5 mg/ X = 0.5 Step 7: Round if necessary. Step 8: Reassess to determine whether the amount to give makes sense. If there are 5 mg/mL and the amount prescribed is 2.5 mg, it makes sense to administer 0.5 mL. The nurse should administer 0.5 mL IV.

A nurse is preparing to administer heparin 8,000 units subcutaneously every 8 hr. Available is heparin 10,000 units/1 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

0.8 mL *Dimensional Analysis STEP #1: What is the unite of measurement the nurse should calculate? mL STEP #2: What is the quantity of the dose available? 1 mL STEP #3: What is the dose available? Dose available = Have 10,000 units STEP #4: What is the dose the nurse should administer? Dose to administer = Desired 8,000 units/hr STEP #5: Should the nurse convert the units of measurement? No STEP #6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/ X mL = 1 mL/10,000 units x 8,000 units/ X = 0.8 STEP #7: Round if necessary. STEP #8: Reassess to determine whether the amount to give makes sense. If there are 10,000 units/1 mL and the amount prescribed is 8,000 units, it makes sense to administer 0.8 mL. The nurse should administer 0.8 mL heparin subcutaneously every 8 hr.

A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a toddler who weighs 22 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

20 mg *Dimensional Analysis STEP #1: What is the unite of measurement the nurse should calculate? kg STEP #2: Set up an equation and solve for X. 2.2 lb/1 kg = client's weight in lb/X kg 2.2 lb/1 kg = 22 lb/X kg X = 10 kg STEP #3: Round if necessary. STEP #4: Reassess to determine whether the conversion to kg makes sense. If 1 kg = 2.2 lb, it makes sense that 22 lb = 10 kg. STEP #3: What is the dose available? Dose available = Have 10,000 units STEP #4: What is the dose the nurse should administer? Dose to administer = Desired 8,000 units/hr STEP #5: Should the nurse convert the units of measurement? No STEP #6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/ X mL = 1 mL/10,000 units x 8,000 units/ X = 0.8 STEP #7: Round if necessary. STEP #8: Reassess to determine whether the amount to give makes sense. If there are 10,000 units/1 mL and the amount prescribed is 8,000 units, it makes sense to administer 0.8 mL. The nurse should administer 0.8 mL heparin subcutaneously every 8 hr.

A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV to infuse over 8 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

21 gtt/min *Dimensional Analysis STEP 1: What is teh unite of measurement the nurse should calculate? gtt/min STEP 2: What is teh volume the nurse should infuse? 1,000 mL STEP 3: WHat is teh total infusion time? 8 hr STEP 4: Should the nurse convert the units of measurement? Yes (hr does not equal min) 1 hr/60 min = 8 hr/X min X = 480 min STEP : Set up an equation and solve for X. Volume (mL)/Time (min) X Drop Factor (gtt/mL) = X. 1,000 mL/480 min x 10 gtt/mL = X gtt/min X = 20.833 STEP 6: Round if necessary. 20.833 = 21 STEP 7: Reassess to determine if the amount to administer makes sense, if the amount prescribed is LR 1,000 mL IV to infuse over 8 hr, it makes sense to administer 21 gtt/min. The nurse should set teh manual IV infusion to deliver LR at 21 gtt/min.

A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

5 mL *Dimensional Analysis STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the quatity of the dose available? 1 mL STEP 3: What is the dose available? Dose available = Have 50 mg STEP 4: What is teh dose the nurse should administer? Dose to administer = Desired 250 mg STEP 5: Should the nurse convert the units of measurement? No STEP 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/ X mL = 1 mL/50 mg x 250 mg/ X = 5 STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to give makes sense. If there are 50 mg/1 mL and the amount prescribed is 250 mg, it makes sense to administer 5 mL. The nurse should administer amoxicillin 5 mL PO.

A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

63 mL/hr *Dimensional Analysis STEP 1: What is the unit of measurement the nurse should calculate? mL/hr STEP 2: What is teh volume the nurse should infuse? 250 mL STEP 3: What is the total infusion time? 4 hr STEP 4: Should the nurse convert the units of measurement? No STEP 5: Set up an equation and solve for X. Volume (mL)/Time (hr) = X mL/hr 250 mL/4 hr = X mL/hr X = 2.5 STEP 6: Round if necessary. 62.5 = 63 STEP 7: Reassess to determine if the amount to administer makes sense. IF the amount prescribed is 250 mL of enteral feeding through an NG tube to infuse over 4 hr, it makes sense to administer 63 mL/hr. The nurse should set the pump to deliver the enteral feeding through the NG at 63 mL/hr.

A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take?

Administer the medication into the client's abdomen *The heparin should be administered into the client's abdomen.

A nurse is assessing a client who has a new prescription for chloropromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering?

Amantadine *The client is experiencing parkinsonism, which is an adverse effect of the antipsychotic medication chlorpromazine. Amantadine is an antiparkinsonian medication used to treat the extrapyramidal manifestations that can occur with chlorpromazine therapy. p

A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority?

Ambulate the client to a chair prior to administering the medication *The nurse should ambulate the client to a chair and ensure that the client is sitting upright before administering the alendronate to prevent esophagitis from occurring. The client must also be able to sit or stand upright for 30 min after taking the medication. The nurse should apply the safety and risk reduction priority-setting framework. This framework assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's Hierarchy of Needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client.

A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?

Antiestrogenic *Tamoxifen is an antiestrogen medication used to treat cancer of the breast in both pre- and postmenopausal women. It is also used to prevent breast cancer in women who are at increased risk.

A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

Electrocardiogram *Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effects of amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status.

A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication?

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.

A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Jaudice Sulfasalazine can cause a yellow discoloration of the skin and yellow/orange discoloration of the urine. The nurse should instruct the client to notify the provider if these occur. *Sulfasalazine can cause nausea, vomiting, and arthralgia, as well as allergic reactions, such as rash.

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions?

Migraine headaches *Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth, which causes vasoconsctriction of dilated cerebral blood vessels.

A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects?

Nephrotoxicity *Amphotericin B is an antifungal medication used to treat severe fungal infections; however, it can cause nephrotoxicity. The nurse should monitor the client's creatinine every 3 to 4 days and increase fluid intake. The dosage of amphotericin B should be reduced if the client's creatinine is 3.5 mg/dL or greater.

A nurse is reviewing the laboratory results for a client who has a prescription for filgrastim. The nurse should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?

Neutrophil count *Filgrastim increases neutrophil production, it is given to treat neutropenia and reduce the risk of infection for clients who are receiving chemotherapy for cancer or who have undergone bone marrow transplant.

A nurse is caring for a client who is at 28 weeks gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer?

Nifedipine *Nifedipine is a tocolytic medication that is administered to stop preterm labor.

A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?

Reduces ammonia levels *Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver.

A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following information should the nurse include in the teaching?

Respiratory depression can occur 7 min after the morphine is administered *Respiratory depression can occur within 7 min following the administration of IV bolus morphine. The nurse should monitor the client's respirations and have naloxone available to reverse the effects of the morphine.

A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effect?

Reye's syndrome *Aspirin should not be given to children or adolescents who have a viral infection, such as chickenpox or influenza, due to the risk of developing Reye's syndrome.

A nurse is providing teaching to a client who has rheumatoid arthritis and a prescription for long-term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects?

Stress fractures *Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures.

A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects?

Superinfection *A superinfection can develop from the overgrowth of fungus due to the antibacterial effect of tetracycline. The nurse should monitor the client for manifestations of a superinfection, such as soreness of the mouth and a swollen tongue.

A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects?

Tachycardia *Adverse effects of epinephrine, an adrenergic agonist, can include tachycardia and dysrhythmias as the result of cardiac stimulation.