Pharm midterm test questions
The nurse is caring for a patient who is on a ventilator for respiratory arrest. Which parenteral anesthetic is also used for sedation during mechanical ventilation in ICU settings?
Propofol (Diprivan)
The nurse is preparing to give a potassium supplement. Which laboratory test should be checked before the patient receives a dose of potassium?
Serum potassium level
A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil (Viagra). He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?
Significant decrease in blood pressure
The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics?
Spironolactone (Aldactone)
Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
"Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes."
A 19-year-old woman has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 6 months, she calls the nurse to say that she feels better and wants to stop the medication. Which response by the nurse is correct?
"Medication therapy for hypothyroidism is usually lifelong, and you should not stop taking the medication."
The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?
"Right time"
A 19-year-old student was diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 1 week, she called the clinic to report that she does not feel better. Which response from the nurse is correct?
"The full therapeutic effects may not occur for several weeks."
When a patient is receiving diuretic therapy, which of these assessment measures would best reflect the patient's fluid volume status?
. Intake, output, and daily weight
When reviewing the health history of a patient, the nurse will note that a potential contraindication to potassium supplements exists if the patient has which problem?
. Renal disease
A patient is to receive hydromorphone (Dilaudid) 1.5 mg IV push now. The medication comes in a prefilled syringe, 2 mg/mL. Identify how many milliliters the nurse will administer for this dose. _______
0.75 mL
A 7-year-old child will be receiving amoxicillin (Amoxil) 50 mg/kg/day in two divided doses. The child weighs 55 pounds. The medication, once reconstituted, is available as an oral suspension of 125 mg/5 mL. Identify how many milliliters will the child receive per dose. _______
25 mL per dose
A patient is to receive a penicillin intramuscular (IM) injection in the ventrogluteal site. The nurse will use which angle for the needle insertion?
90 degrees
Before administering any medication, what is the nurse's priority action regarding patient safety?
Checking the patient's identification using two identifiers
The nurse recognizes that an elderly patient may experience a reduction in the stomach's ability to produce hydrochloric acid. This change may result in which effect?
Altered absorption of some drugs
Drug transfer to the fetus is more likely during the last trimester of pregnancy fir which reason?
Enhanced blood flow to the fetus
A patient is receiving oxytocin (Pitocin) to induce labor. During administration of this medication, the nurse will also implement which action?
Administering the medication with an IV infusion pump
During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?
Avoiding foods containing iodine
The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safe category
Category D
The nurse is developing a human needs statement for a patient who has a new diagnosis of heart failure. Identification of human needs statements occur with which of these activities?
Collection of patient data
The medication order reads, "Give ondansetron (Zofran) 4 mg, 30 minutes before beginning chemotherapy to prevent nausea." The nurse notes that the route is missing from the order. What is the nurse's best action?
Contact the prescriber to clarify the route of the medication ordered
. When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse will monitor for which adverse effect?
Decreased white blood cell count
. During the immediate postoperative period, the Post Anesthesia Care Unit nurse is assessing a patient who had hip surgery. The patient is experiencing tachycardia, tachypnea, and muscle rigidity, and his temperature is 103° F (39.4° C). The nurse will prepare for what immediate treatment?
Dantrolene (Dantrium) injection, a skeletal muscle relaxant
After administering an intradermal (ID) injection for a skin test, the nurse notices a small bleb at the injection site. Which of these is the best action for the nurse to take at this time?
Do nothing.
When monitoring a patient who has diabetes and is receiving a carbonic anhydrase inhibitor for edema, the nurse will monitor for which possible adverse effect?
Elevated blood glucose
The nurse has been monitoring the patient's progress on a new drug regimen since the first dose and documenting the patient's therapeutic response to the medication. Which phase of the nursing process do these actions illustrate?
Evaluation
An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her daughter should be told to watch for which problems?
Fatigue, leg cramps, and dehydration
During an infusion of albumin, the nurse monitors the patient closely for the development of which adverse effect?
Fluid volume overload
The nurse is administering an IV push medication through an IV lock. After injecting the medication, which action will be taken next?
Flushing the lock
The nurse is trying to give a liquid medication to a -year-old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to this child?
Give the medication with a spoonful of ice cream.
A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very independent and wants to continue to live at home. The nurse will know that which teaching point is important for this patient?
He needs to take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.
The nurse is teaching a patient about the adverse effects of fertility drugs such as clomiphene (Clomid). Which is a potential adverse effect of this drug?
Headache
During a fishing trip, a patient pierced his finger with a large fishhook. He is now in the emergency department to have it removed. The nurse anticipates that which type of anesthesia will be used for this procedure?
Infiltration of the puncture wound with lidocaine
Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure?
Intravenously, through a filter
A patient who is taking propylthiouracil (PTU) for hyperthyroidism wants to know how this medicine works. Which explanation by the nurse is accurate?
It slows down the formation of thyroid hormone.
A 21-year-old male athlete admits to using androgenic steroids. The nurse tells him that which of these is a possible adverse effect of these drugs?
Liver damage
While monitoring a patient who had surgery under general anesthesia 2 hours ago, the nurse notes a sudden elevation in body temperature. This finding may be an indication of which problem?
Malignant hyperthermia
A patient is being treated for secondary amenorrhea. The nurse expects which drug to be used to treat this problem?
Medroxyprogesterone (Provera)
When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?
Milligram per kilogram of body weight formula
For accurate medication administration to pediatric patients, the nurse must take into account which criteria?
Organ maturity
When monitoring a patient for signs of hypokalemia, the nurse looks for what early sign?
Muscle weakness
The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child?
Offer a brief, concrete explanation of the procedure at the patient's level and with the parent or caregiver present.
A patient is in an urgent care center and is receiving treatment for mild hyponatremia after spending several hours doing gardening work in the heat of the day. The nurse expects that which drug therapy will be used to treat this condition?
Oral administration of sodium chloride tablets
The nurse is reviewing the medication list of a patient who will be starting androgen therapy. Which drug classes, if taken with androgens, may have an interaction with them?
Oral anticoagulants
The nurse needs to administer insulin subcutaneously to an obese patient. Which is the proper technique for this injection?
Pinching the skin at the injection site, and then inserting the needle to below the tissue fold at a 90-degree angle
When administering medication by IV bolus (push), the nurse will occlude the IV line by which method?
Pinching the tubing just above the injection port
When giving a buccal medication to a patient, which action by the nurse is appropriate?
Placing the medication between the upper or lower molar teeth and the cheek
A woman visits a health center requesting oral contraceptives. Which laboratory test is most important for the nurse to assess before the patient begins oral contraceptive therapy?
Pregnancy test
Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension?
Providing education on keeping a journal of blood pressure readings
A patient, newly diagnosed with hypothyroidism, receives a prescription for a thyroid hormone replacement drug. The nurse assesses for which potential contraindication to this drug?
Recent myocardial infarction
When giving medications, the nurse will follow the rights of medication administration. The rights include the right documentation, the right reason, the right response, and the patient's right to refuse. Which of these are additional rights? (Select all that apply.)
Right drug Right route Right dose Right time Right patient
The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug?
Sedatives
When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to anesthesia?
The 82-year-old patient who is to have gallbladder removal
A patient with hypothyroidism is given a prescription for levothyroxine (Synthroid). When the nurse explains that this is a synthetic form of the thyroid hormone, he states that he prefers to receive more "natural" forms of drugs. What will the nurse explain to him about the advantages of levothyroxine?
The half-life of levothyroxine is long enough to permit once-daily dosing
The nurse is working with a graduate nurse to prepare an intravenous dose of potassium for a patient on a regular medical-surgical unit. Which statement by the graduate nurse reflects a need for further teaching?
The intravenous potassium dose will be given undiluted."
Which statements are true regarding the elderly and pharmacokinetics? (Select all that apply.)
The levels of microsomal enzymes are decreased. Fat content is increased because of decreased lean body mass. The number of intact nephrons is decreased. Gastric pH is less acidic.
Which statements are true regarding pediatric patients and pharmacokinetics? (Select all that apply.)
The levels of microsomal enzymes are decreased. Perfusion to the kidneys may be decreased and may result in reduced renal function First-pass elimination is reduced because of the immaturity of the liver. Gastric emptying is slowed because of slow or irregular peristalsis
The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity
The liver is not fully developed.
The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity?
The liver is not fully developed.
The nurse will plan to use the Z-track method of intramuscular (IM) injections for which situation?
The medication is known to be irritating to tissues
The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data?
The patient reports that he uses the herbal product ginkgo.
The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
The patient uses multiple medications simultaneously
The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient?
The patient will demonstrate correct blood glucose testing technique.
An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?
The patient will receive the lowest possible dose at first, and then the dose will be increased as needed.
When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug?
The patient's last meal
When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about loop diuretics?
They have a rapid onset of action and cause rapid diuresis
A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially?
Thiazide diuretics
The nurse has an order to administer an intramuscular (IM) immunization to a 2-month-old child. Which site is considered the best choice for this injection?
Vastus lateralis
The nurse is measuring 4 mL of a liquid cough elixir for a child. Which method is most appropriate?
Withdrawing the elixir from the container using a calibrated oral syringe
A patient is receiving finasteride (Proscar) for treatment of benign prostatic hyperplasia. The nurse will tell him that a possible effect of this medication is:
increased hair growth
When a male patient is receiving androgen therapy, the nurse will monitor for signs of excessive androgens such as:
fluid retention.
During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased:
risk for thrombosis.
