pharm exam 1- chapter 3 PrepU practice questions

A client with recurrent urinary tract infections was prescribed sulfamethoxazole-trimethoprim and experienced an allergic reaction. The client states, "I don't understand. I had a two-day course of the same drug last year with no problems." What is the nurse's best response? a.) "Allergic reactions happen after your body has been sensitized to a drug in the past." b.) "Allergic reactions are usually dose-dependent, so it could be that you were treated with a lower dose last year." c.) "It's likely that you didn't have an allergic reaction last time because you had such a short course of treatment." d.) "If you were more ill with an infection last time, it's possible you confused an allergic reaction with your UTI symptoms."

a.) "Allergic reactions happen after your body has been sensitized to a drug in the past."

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects? a.) Be sure to drink plenty of fluids to prevent dehydration. b.) Eat a low-fiber diet to prevent constipation. c.) Avoid strenuous exercise to minimize calorie loss d.) Try to stay as warm as possible to prevent chilling.

a.) Be sure to drink plenty of fluids to prevent dehydration.

The nurse is caring for a client who appears to be developing anaphylactic shock. What drug does the nurse anticipate the health care practitioner will order to treat this condition? a.) Epinephrine (Adrenalin) b.) Acetylsalicylic acid (Aspirin) c.) Furosemide (Lasix) d.) Acetaminophen (Tylenol)

a.) Epinephrine (Adrenalin)

A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan? a.) Safety measures b.) The need for follow-up blood tests c.) Educating about the signs and symptoms of stroke d.) The importance of a low-stimulation environment

a.) Safety measures

All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug? a.) Stevens-Johnson syndrome b.) Atropine-like (cholinergic) effects c.) Neuroleptic malignant syndrome (NMS) d.) Parkinson-like syndrome

a.) Stevens-Johnson syndrome

The nurse is assessing a number of clients on the acute medicine unit. What client is most likely experiencing an adverse effect from the primary action of the medication? a.) a client taking antihypertensives who reports dizziness upon standing b.) a client whose upper gastrointestinal bleed is attributed to nonsteroidal anti-inflammatories c.) a client taking oral antibiotics who has experienced nausea after each dose d.) a client whose antidepressant has caused sexual dysfunction in the past

a.) a client taking antihypertensives who reports dizziness upon standing

A client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a: a.) contraindication for the use of certain medications. b.) basis for planning the medication regimen. c.) prominent part of client teaching. d.) basis for the nursing care plan.

a.) contraindication for the use of certain medications.

The nurse is caring for a client with hypertension who was prescribed a loop diuretic one week ago. The client reports malaise and weakness and the nurse's assessment reveals an irregular heart rate. The nurse should prioritize assessment of the client's: a.) potassium levels. b.) cognition. c.) liver enzyme levels. d.) renal function.

a.) potassium levels.

Which client is experiencing a secondary action of a medication? a.) A client who has developed hives and a rash after taking an antibiotic b.) A client who is drowsy after taking antihistamine c.) A client who is lethargic after taking an antianxiety medication d.) A client who is in respiratory distress with elevated blood pressure after taking an antiviral medication

b.) A client who is drowsy after taking antihistamine

A client with urinary urgency and frequency has been prescribed an anticholinergic medication. The nurse should educate the client about what potential adverse effects related to secondary actions? a.) Urinary incontinence b.) Decreased bowel motility c.) Urinary hesitancy d.) Anaphylaxis

b.) Decreased bowel motility

A client develops a cytotoxic reaction to a drug. What would the nurse expect to do? a.) Administer antipyretics as ordered. b.) Discontinue the drug immediately as ordered. c.) Encourage the use of MedicAlert identification. d.) Administer prescribed epinephrine subcutaneously.

b.) Discontinue the drug immediately as ordered.

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform? a.) Check the client's urine output. b.) Review the client's most recent potassium level. c.) Assess the client's level of orientation. d.) Check the client's blood glucose level.

b.) Review the client's most recent potassium level.

The nurse is caring for a client who is receiving an antidiabetic agent. What assessment finding should the nurse attribute to a possible adverse reaction? a.) The client states, "I just can't seem to quench my thirst." b.) The client reports feeling unusually drowsy and fatigued. c.) The nurse's assessment reveals Kussmaul respirations. d.) The client has voided three times in the past hour.

b.) The client reports feeling unusually drowsy and fatigued.

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion? a.) The client's albumin, bilirubin, AST and ALT levels b.) The client's blood urea nitrogen level and creatinine clearance rate c.) The client's fasting blood glucose level d.) The client's body mass index and hydration status

b.) The client's blood urea nitrogen level and creatinine clearance rate

What is an example of a secondary action? a.) urinary retention develops in a client with an enlarged prostate who is taking an anticholinergic b.) an antihistamine causes the client to experience drowsiness c.) anticoagulant that leads to excessive and spontaneous bleeding. d.) dizziness and weakness with a recommended dose of antihypertensive

b.) an antihistamine causes the client to experience drowsiness

The nurse is caring for a client with a drug allergy and understands the allergy is the result of the client developing: a.) antigens. b.) antibodies. c.) secondary effects. d.) antihistamine.

b.) antibodies.

Which drug allergy involves antibodies bound to specific white blood cells? a.) serum sickness reaction b.) delayed allergic reaction c.) anaphylactic reaction d.) cytotoxic reaction

b.) delayed allergic reaction

A client develops stomatitis from drug therapy. Which measure would be most appropriate for the nurse to suggest? a.) brushing of teeth with a firm toothbrush b.) frequent rinsing with cool liquids c.) the use of an astringent mouthwash d.) consumption of three large meals per day

b.) frequent rinsing with cool liquids

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug can cause: a.) hyperkalemia. b.) hypoglycemia. c.) hypokalemia. d.) hyperglycemia.

b.) hypoglycemia.

A client exhibiting Parkinson-like syndrome would be expected to have which manifestation upon assessment? a.) hyperactivity b.) muscular tremors c.) dry mouth d.) flaccidity

b.) muscular tremors

A patient with a severe infection is given gentamicin, the only antibiotic shown to be effective in culture and sensitivity tests. A few hours after the drug is started intravenously, the patient becomes very restless and develops edema. Blood tests reveal abnormal electrolytes and elevated blood urea nitrogen. This reaction was most likely caused by a.) an anaphylactic reaction b.) renal toxicity associated with gentamicin c.) superinfection related to the antibiotic d.) hypoglycemia

b.) renal toxicity associated with gentamicin

The nurse at a campus medical clinic is administering a new medication to a 22-year-old female client. The nurse should educate the client about what potential risk of drug therapy? a.) poisoning b.) teratogenicity c.) secondary effects d.) primary effects

b.) teratogenicity

A patient has had repeated bouts of bronchitis throughout the fall and has been taking antibiotics. They call the clinic with complaints of vaginal pain and itching. When they are seen, it is discovered that they have developed a yeast infection. You understand that a.) the patient's bronchitis has moved to the vaginal area b.) the patient has developed a superinfection, because the antibiotics kill bacteria that normally provide protection c.) the patient probably has developed a sexually transmitted disease d.) the patient will need to take even more antibiotics to treat this new infection

b.) the patient has developed a superinfection, because the antibiotics kill bacteria that normally provide protection

The nurse is providing for a client who is being treated for a Pseudomonas infection in the intensive care unit. The client's medication regimen includes gentamicin 75 mg IV t.i.d. When monitoring the client for adverse effects, what assessment should the nurse prioritize? a.) fine motor skills and observation for tremors b.) urine output and creatinine clearance c.) orientation, judgment, and level of consciousness d.) electrolyte levels and heart rhythm

b.) urine output and creatinine clearance

A client with a history of schizophrenia was admitted during a psychotic episode and has received several doses of haloperidol. The client's cognitive status has stabilized but assessment reveals clammy skin, respiratory rate of 31 breaths per minute, and heart rate of 102 beats per minute. What is the nurse's best action? a.) Check the client's most recent potassium level. b.) Perform a mental status assessment. c.) Assess the client's blood glucose level. d.) Arrange for cardiac monitoring.

c.) Assess the client's blood glucose level.

A client with a recent history of peripheral edema has been taking hydrochlorothiazide 75 mg PO daily. The client reports increased appetite and restlessness to the nurse and inspection reveals warm, flushed skin. What is the nurse's best action? a.) Assess the client's blood pressure. b.) Measure the client's abdominal girth and weight. c.) Assess the client's blood glucose level. d.) Encourage fluid intake.

c.) Assess the client's blood glucose level.

When assessing a client who has developed an anaphylactic reaction, what would the nurse expect to find? a.) Swollen lymph nodes b.) Decreased hematocrit c.) Difficulty breathing d.) Swollen joints

c.) Difficulty breathing

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include? a.) Most reactions occurring with present-day therapy are less severe than before. b.) Many drugs are potentially harmless if used correctly. c.) Drugs cause unexpected or unacceptable reactions despite screening and testing. d.) Any effect results from the alteration of several chemical factors.

c.) Drugs cause unexpected or unacceptable reactions despite screening and testing.

A client with an anxiety disorder has been prescribed alprazolam 0.5 mg PO t.i.d. During a follow-up assessment, the client tells the nurse that the medication causes drowsiness that interferes with the client's work performance. What is the nurse's best action? a.) Assess the client for any other secondary actions of the medication. b.) Instruct the client to stop taking to medication immediately and to come be assessed. c.) Educate the client about strategies for managing this primary action. d.) Dialogue with the client about alternative medications.

c.) Educate the client about strategies for managing this primary action.

A client is suspected of having a liver injury as a result of drug therapy. What laboratory finding would best support this diagnosis? a.) Elevated blood urea nitrogen (BUN) b.) Sudden drops in hemoglobin, hematocrit and red cell count c.) Elevated aspartate aminotransferase (AST) level d.) Elevated serum creatinine level

c.) Elevated aspartate aminotransferase (AST) level

What does the nurse need to do when there is any indication of an allergic reaction in clients? a.) Reduce the risk of adverse effects during drug therapy. b.) Increase the effectiveness of a specific medication. c.) Maintain the client's safety during drug therapy. d.) Obtain early warning of noncompliance in drug therapy.

c.) Maintain the client's safety during drug therapy.

A client with a longstanding diagnosis of schizophrenia has taken antipsychotic drugs for several decades. For what adverse effect should the nurse assess? a.) Dry mouth and urinary hesitation b.) Hyperthermia c.) Parkinsonian symptoms d.) Hypoglycemia

c.) Parkinsonian symptoms

A few minutes after starting an intravenous (IV) infusion of a newly prescribed antibiotic, the client develops difficulty breathing, hives, and a rapid heart rate. Which action will the nurse take first? a.) Notify the health care provider. b.) Maintain the airway. c.) Stop the infusion. d.) Monitor blood pressure.

c.) Stop the infusion.

A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client? a.) The rationale for prophylactic antibiotics b.) The rationale for taking probiotics for the duration of treatment c.) Techniques for providing safe and effective mouth care d.) The importance of sitting upright while eating and for 30 minutes afterwards

c.) Techniques for providing safe and effective mouth care

A client is believed to be developing neuroleptic malignant syndrome. What is the nurse's assessment priority? a.) Oxygen saturation b.) Cognition c.) Temperature d.) Deep tendon reflexes

c.) Temperature

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? a.) The man may be experiencing liver toxicity from the aspirin b.) The man may be experiencing a paradoxical effect of aspirin c.) The man may be experiencing nephrotoxic effects of aspirin d.) The man may be allergic to aspirin

c.) The man may be experiencing nephrotoxic effects of aspirin

The nurse administers an anticholinergic medication to the client. When assessing this client, what finding should the nurse interpret as a secondary effect of the drug? a.) Profuse sweating b.) Tachycardia c.) Urinary hesitancy d.) Hyperthermia

c.) Urinary hesitancy

The nurse is assessing a client who has developed shortness of breath, a rash, panic and a blood pressure of 189/106 mm Hg after being administered a new medication. In addition to promptly informing the care team, the nurse should perform what action? a.) providing supplementary oxygen by nasal cannula b.) administering monoclonal antibodies as prescribed c.) administering epinephrine as prescribed d.) performing cardiopulmonary resuscitation

c.) administering epinephrine as prescribed

Preoperative atropine belongs to what classification of drugs? a.) cholinergic b.) benzodiazepine c.) anticholinergic d.) diuretic

c.) anticholinergic

An example of a drug allergy is a.) dry mouth occurring with use of an antihistamine b.) increased urination occurring with use of a thiazide diuretic c.) breathing difficulty after an injection of penicillin d.) urinary retention associated with atropine use

c.) breathing difficulty after an injection of penicillin

Knowing that a patient is taking a loop diuretic and is at risk for developing hypokalemia, the nurse would assess the patient for a.) hypertension, headache, and cold and clammy skin. b.) decreased urinary output and yellowing of the sclera. c.) weak pulse, low blood pressure, and muscle cramping. d.) diarrhea and flatulence.

c.) weak pulse, low blood pressure, and muscle cramping.

The nurse is assessing a community-dwelling client with a history of rheumatoid arthritis. During the interview, the client states, "The last few months, I have this ringing in my ears that I just cannot seem to get away from." What assessment question should the nurse ask? a.) "Are you taking any herbal remedies or vitamin supplements?" b.) "Have you ever had any steroid injection to treat your arthritis?" c.) "Do you ever check your blood pressure when you're at home?" d.) "Have you been taking aspirin on a regular basis?"

d.) "Have you been taking aspirin on a regular basis?"

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse? a.) "This is an idiosyncratic response to the medication, not an expected result. Such responses are genetically predetermined so you will not be able to take this medication." b.) "This is a toxic reaction to the medication and can cause permanent damage. We need to take you off this medication immediately." c.) "The sexual dysfunction is caused by an allergic reaction to the medication. We need to stop this drug immediately." d.) "This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

d.) "This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

What client is experiencing an adverse effect that is a result of primary action? a.) An older adult client who becomes agitated and disoriented after being given a narcotic b.) A client who takes an antihistamine and falls asleep c.) A client who develops diarrhea shortly after beginning a course of antibiotics d.) A client taking anticoagulants who develops a gastrointestinal bleed

d.) A client taking anticoagulants who develops a gastrointestinal bleed

A client diagnosed with cancer has been receiving antineoplastics for several weeks. What assessment finding should the nurse interpret as a possible indication of blood dyscrasia? a.) Platelet level of 350,000/mm3 (350 x 109/L) b.) International normalized ratio of 1.1 c.) Serum creatinine of 1.2 mg/dL (110 ?mol/L) d.) Hemoglobin of 6.0 g/dL (60.0 g/L)

d.) Hemoglobin of 6.0 g/dL (60.0 g/L)

Upon assessment after giving oral penicillin, the nurse notes that a client has dilated pupils, increased blood pressure, and increased heart rate. The nurse would document these findings as which type of drug allergic reaction? a.) cytotoxic b.) serum sickness c.) delayed d.) anaphylactic

d.) anaphylactic

A client exhibits muscular tremors, drooling, gait changes, and spasms. When reviewing the client's medication history, which would the nurse most likely find? a.) antidiabetic agent b.) anticholinergic agent c.) general anesthetic d.) antipsychotic agent

d.) antipsychotic agent

The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize? a.) assessing the client's pain tolerance and expectations for pain control b.) asking if the client has tolerated narcotics and acetaminophen in the past c.) assessing the client for signs and symptoms of inflammation d.) asking the client what the client's response is to taking NSAIDs

d.) asking the client what the client's response is to taking NSAIDs

A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize: a.) skin integrity. b.) sodium, potassium, and chloride levels. c.) AST, ALT and bilirubin levels. d.) blood urea nitrogen and creatinine levels.

d.) blood urea nitrogen and creatinine levels.

Patients receiving antineoplastic drugs that disrupt cell function often have adverse effects involving cells that turn over rapidly in the body. These cells include a.) ovarian cells. b.) liver cells. c.) cardiac cells. d.) bone marrow cells.

d.) bone marrow cells.

A patient taking glyburide (an antidiabetic drug) has their morning dose and then does not have a chance to eat for several hours. An adverse effect that might be expected from this would be a.) a teratogenic effect b.) a skin rash c.) an anticholinergic effect d.) hypoglycemia

d.) hypoglycemia

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of: a.) allergies. b.) anaphylaxis. c.) hypersensitivity. d.) poisoning.

d.) poisoning.

The pharmacology instructor explains to the students that adverse effects can be extensions of: a.) fourth level effects. b.) anaphylaxis. c.) anticholinergic responses to the drug. d.) primary action of a drug.

d.) primary action of a drug.

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of: a.) primary actions. b.) hypersensitivity. c.) drug allergy. d.) secondary actions.

d.) secondary actions.

For several days, a client with hypertension has been inadvertently taking an excessive dose of spironolactone, a potassium-sparing diuretic. The client has presented to the emergency department with signs and symptoms that suggest hyperkalemia. What assessment should the nurse prioritize? a.) blood glucose monitoring b.) assessment for signs of hepatotoxicity c.) urine output and assessment of renal function d.) respiratory assessment e.) cardiac monitoring

e.) cardiac monitoring