Pharmacology exam
19. The patient has been taking bethanechol and is experiencing flushing, sweating, nausea, and abdominal cramps. Which action would be best for the nurse to take? a. Document the patient manifestations. b. Give the patient a laxative. c. Increase the patient's fluid intake. d. Obtain an order to administer atropine.
d
23. After a patient received an epidural the blood pressure begins to decrease. Which initial nursing action would be correct? a. Administer oxygen. b. Expect an order to administer 5-15 mg of ephedrine IV. c. Expect an order to transfuse with 1 unit of packed red cells. d. Turn her on her left side.
d
A patient calls the home health agency to tell the nurse about shaking and trembling after using the albuterol inhaler. Which question would the nurse first ask the patient? a. "Are you having any other symptoms?" b. "How long ago did this start?" c. "When was the last time you used your inhaler?" d. "How many puffs on the inhaler did you take?"
d
10. Which drug would the nurse anticipate administering to a patient who ingested an organophosphate poison? a. Bethanechol b. Edrophonium chloride c. Metoclopramide d. Pralidoxime chloride
d.
11. Which medical condition would sildenafil be contraindicated? a. Hepatitis b. Seizure disorder c. Renal insufficiency d. Unstable angina
d.
11. Which substance would be administered to a neonate born to a hepatitis B carrier to provide passive protection against hepatitis B? a. Recombinant hepatitis B b. Varicella zoster c. Phytonadione d. Hepatitis B immune globulin
d.
18. The patient has been prescribed bethanechol and is experiencing decreased urinary output. Which action would be a priority by the nurse? a. Catheterize the patient to drain the bladder and measure output. b. Encourage the patient to increase fluid intake to increase urinary output. c. Encourage the patient to relax when urinating. d. Notify the health care provider with current intake and output values.
d.
21. A baby with respiratory depression was born within 15 minutes after the mother received opioids for pain. Which drug would the nurse anticipate administering to provide reversal of neonatal respiratory depression? a. Calcium gluconate b. Calcium carbonate c. Flumazenil d. Naloxone
d.
22. The nurse would question a prescription for atropine for a patient with which disorder? a. Peptic ulcer b. Parkinsonism c. Cirrhosis d. Narrow-angle glaucoma
d.
23. A patient with peptic ulcer disease has been on propantheline bromide 15 mg 30 minutes before meals and 30 mg at bedtime. Which action describes propantheline bromide? a. It blocks H2 receptors. b. It coats the lining of the stomach. c. It increases gastric motility. d. It inhibits gastric secretions.
d.
26. A specific group of anticholinergics may be prescribed in the early treatment of which neuromuscular disorder? a. Multiple sclerosis b. Muscular dystrophy c. Myasthenia gravis d. Parkinsonism ]
d.
33. Which patient would laxative/cathartic be contraindicated? a. A patient with cirrhosis b. A patient with parkinsonism c. A patient with stable angina d. A patient with bowel obstruction
d.
6. A baby is born at 30 weeks' gestation and is having respiratory distress. Which class of drug would be given to help distend alveoli? a. Antibiotics b. Benzodiazepines c. Calcium chloride d. Surfactant replacement
d.
12. Anticholinergic eyedrops are used for which purpose? a. Constrict the pupils b. Dilate the pupils c. Decrease the intraocular pressure d. Detect astigmatism
B
32. Which adrenergic drug used in emergency settings does not decrease renal function? a. Norepinephrine b. Dopamine c. Phenylephrine d. Dobutamine
D
19. The patient has received spinal anesthesia for delivery. Which alteration would the nurse monitor? a. Decreased hemoglobin and hematocrit b. Palpitations c. Pedal edema d. Postdural headache
D.
31. Which nursing intervention would be a priority to implement in the care of a patient taking prednisone? (Select all that apply.) a. Follow the physical therapy regimen. b. Monitor for signs and symptoms of hyponatremia. c. Monitor vital signs. d. Obtain a complete medication history. e. Record daily weight.
a
21. The nurse is taking care of five patients in the emergency department. A patient with which disorder would receive atropine? (Select all that apply.) a. Surgery for appendicitis b. A heart rate of 38 beats/minute and dizziness c. Paralytic ileus d. Urinary retention e. Gastric ulcers
a,b
25. A patient who is 38 weeks pregnant and complaining of a sinus headache takes a combination drug that contains aspirin, acetaminophen, and caffeine. Which event can occur with the use of aspirin late in pregnancy? (Select all that apply.) a. Decreased hemostasis in the newborn b. Increased maternal blood loss at delivery c. Increased risk of anemia d. Low-birth-weight infant e. Precipitous delivery
a,b,c
30. When completing the patient health history, the nurse finds a history of narrow-angle glaucoma. When performing the drug reconciliation, which drug would concern the nurse? (Select all that apply.) a. Pseudoephedrine b. Midodrine c. Albuterol d. Carvedilol
a,b,c
26. The nurse is assessing a patient taking zidovudine. Which common side effects would the nurse assess for? (Select all that apply.) a. Constipation b. Headache c. Myalgia d. Rash e. Seizures
a,b,c,d
25. Which class of drugs can be used as antiemetics? (Select all that apply.) a. Anticholinergics b. Antihistamines c. Cannabinoids d. Opioids e. Phenothiazines
a,b,c,e
13. Which important factor determine the teratogenicity of any drug ingested during pregnancy? (Select all that apply.) a. Dosage b. Duration of exposure c. Gastric motility d. Timing e. Urinary clearance
a,b,d
18. In which patient would combined hormone contraceptives (CHCs) be used with caution? (Select all that apply.) a. 37-year-old who smokes b. 45-year-old who does not exercise c. 38-year-old with diabetes d. 28-year-old with epilepsy e. 18-year-old with depression
a,b,d
26. The patient is receiving magnesium sulfate for gestational hypertension. Which side effect may be expected? (Select all that apply.) a. Dizziness b. Flushing c. Hyperreflexia d. Slurred speech e. Urinary incontinence
a,b,d
25. A patient is taking ranitidine for gastroesophageal reflux disease (GERD). Which side effect of ranitidine would the nurse monitor in this patient? (Select all that apply.) a. Confusion b. Headache c. Hypertension d. Erectile dysfunction e. Nausea
a,b,d,e
29. The patient is receiving diphenoxylate with atropine for diarrhea. Which side effect would the nurse expect to see during treatment? (Select all that apply.) a. Headache b. Drowsiness c. Hypertension d. Hypoglycemia e. Urinary retention
a,b,e
17. Which outcome to the body would occur from receiving large doses of cholinergic drugs? (Select all that apply.) a. Decreased blood pressure b. Decreased salivation c. Increased bronchial secretions d. Mydriasis e. Urinary retention
a,c
27. The nurse assesses a patient receiving a regional anesthesia for side effects. Which side effect would the nurse monitor? (Select all that apply.) a. Dizziness b. Hypertension c. Metallic taste in mouth d. Nausea e. Palpitations
a,c
25. Anticholinergic drugs are contraindicated in patients with which disorder? (Select all that apply.) a. Coronary artery disease b. Diabetes mellitus c. Gastrointestinal obstruction d. Supraventricular tachycardia
a,c,d
18. A pregnant patient presents to her health care provider with complaints of morning sickness. "I didn't have it with my first. I'm just not sure what to do." Which nonpharmacologic measure would the nurse suggest? (Select all that apply.) a. Avoid fatty or spicy foods. b. Avoid fluids before arising. c. Drink flat soda between meals. d. Eat crackers, dry toast, cereal, or complex carbohydrates. e. Eat a high-protein snack at bedtime.
a,c,d,e
17. Which indication would be appropriate for antiandrogen drugs? (Select all that apply.) a. Advanced prostatic cancer b. Erectile dysfunction c. Male pattern baldness d. Menopausal symptoms e. Benign prostatic hypertrophy (BPH)
a,c,e
21. If therapy is to be initiated, the selection of antiretroviral therapy (ART) would be based on which patient status? (Select all that apply.) a. Patient's other comorbid conditions b. Patient's age and support system c. Patient's willingness to accept therapy d. Probability of adherence to therapy e. Pregnancy status
a,c,e
18. A nurse is teaching a patient who is positive for human immunodeficiency virus (HIV). Which statement by the patient indicates a need for further teaching on HIV transmission? (Select all that apply.) a. "It is okay to share my razor." b. "I need to wear a condom with any type of sexual intercourse." c. "I can spread HIV by sharing my toothbrush." d. "I can donate my sperm."
a,d
25. During the time that a patient is taking zidovudine, frequent monitoring of which laboratory value is required? (Select all that apply.) a. Liver enzymes ALT/AST b. Complete blood count (CBC) with differential c. Creatinine d. Serum sodium e. Urine sedimentation rate
a,d,c
21. Which drug would mostly have a drug-drug interaction with oral conjugated estrogen? (Select all that apply.) a. Aspirin b. Fluoxetine c. Folic acid d. Phenobarbital e. Topiramate
a,d,e
11. The pediatric patient has urinary retention. Which cholinergic drug would the nurse anticipate will be prescribed to increase urination? a. Bethanechol b. Edrophonium chloride c. Metoclopramide d. Neostigmine bromide
a.
12. The mechanism in which drugs cross the placenta is similar to the way drugs infiltrate which type of body tissue? a. Breast b. Liver c. Subcutaneous d. Uterine
a.
14. A patient who is receiving androgen therapy takes prescribed drugs for cardiovascular disease, diabetes, and chronic obstructive pulmonary disease. Which drug-drug interaction can occur in this patient? a. Androgens may decrease blood glucose levels, and insulin doses must be adjusted. b. Androgens decrease the effect of anticoagulants. c. Phenytoin potentiates the action of androgens. d. There are no interactions with steroids.
a.
20. Which food would the nurse recommend to eat to increase iron intake during pregnancy? a. Broccoli b. Cabbage c. Apples d. Potatoes
a.
22. Before administration of general anesthesia, a laboring woman is given an antacid. Which purpose of giving this drug is correct? a. Decrease gastric acidity b. Enhance anesthesia induction c. Maintain a patent airway d. Prevent nausea and vomiting
a.
22. Which drug is the most commonly ingested nonprescription drug for pain during pregnancy? a. Acetaminophen b. Aspirin c. Diphenhydramine d. Ibuprofen
a.
25. During which stage of labor are ergot alkaloids administered? a. First b. Second c. Third d. Fourth
a.
31. The patient who is scheduled for a barium enema is prescribed bisacodyl the day before the procedure. Which response by the nurse would be appropriate when the patient asks how bisacodyl works? a. "Bisacodyl increases peristalsis by irritating the lining of the intestines." b. "By stimulating more smooth muscle contraction, bisacodyl will cause your bowel to empty." c. "Bisacodyl increases water in the gut." d. "Bisacodyl is an emetic, so you will vomit, and your stomach will be empty for the test."
a.
34. A patient tells the nurse during the admitting history that alternative and complementary therapies are used to help manage medical conditions. Which drug would raise a concern in a patient taking St. John's wort? a. Reserpine b. Albuterol c. Propranolol d. Pseudoephedrine
a.
20. A patient who has been taking conjugated estrogen for contraception reports a variety of side effects. Which clinical manifestation is due primarily to an excess of estrogen? (Select all that apply.) a. Acne b. Breast tenderness c. Fluid retention d. Leg cramps e. Nausea
all of them
10. A preterm neonate becomes cyanotic and the oxygen level decreases during surfactant administration. Which action would be most appropriate by the nurse? a. Gently suction through the endotracheal tube immediately to raise the oxygen level. b. Reposition the neonate to disperse the drug throughout the lungs. c. Do nothing. d. Increase the amount of oxygen the neonate is receiving.
b
19. Which laboratory test is used to monitor the efficacy of human immunodeficiency virus (HIV) drug therapy? a. White blood cell count b. CD4+ T-cell count c. Plasma B-cells d. Complete blood count
b
26. A patient with severe nausea and vomiting asks how promethazine works. Which response by the nurse would be correct? a. "It stimulates the dopamine receptors in the brain associated with vomiting." b. "It blocks the histamine receptor sites and inhibits the CTZ." c. "It blocks the acetylcholine receptors associated with vomiting." d. "It prohibits the muscle contraction in the abdominal wall, preventing vomiting."
b
31. Some over-the-counter (OTC) drugs for cold symptoms contain substances that have sympathetic properties. These drugs are contraindicated in patients with which disease process? a. Allergic rhinitis b. Hypertension c. Orthostatic hypotension d. Chronic bronchitis
b
Which type of medication is bethanechol? a. Anticholinergic b. Cholinergic agonist c. Cholinesterase inhibitor d. Sympatholytic
b
22. Drug adherence has improved since the advent of antiretroviral therapy (ART). Which advancements to antiretroviral therapy (ART) helped in increasing adherence? a. More pill burden b. Increased potency of newer ART c. Improved side effect profile d. Decreased potency of newer ART to reduce side effects
b,c
28. Which baseline data would the nurse collect on a patient who is being inducted at 41+ weeks with intravenous (IV) oxytocin? (Select all that apply.) a. Deep tendon reflexes b. Fetal heart rate c. Pulse rate and blood pressure d. Type and crossmatch for blood e. Uterine activity
b,c,d,e
19. A pregnant patient in her first trimester of pregnancy was started on a prenatal vitamin with iron. Which teaching would the nurse provide? (Select all that apply.) a. Antacids can be taken with the iron tablet to help with epigastric discomfort. b. Ensure adequate fluid and fiber intake to assist with constipation. c. Iron can be taken with food if necessary to prevent nausea. d. Jaundice is a common side effect of iron supplements. e. Orange juice enhances iron absorption.
b,c,e
28. Which drug is classified as beta blockers? (Select all that apply.) a. Albuterol b. Atenolol c. Propranolol d. Amphetamine e. Acebutolol
b,c,e
15. The patient has been diagnosed with gestational hypertension. Which treatment goal would be appropriate? (Select all that apply.) a. Decrease the incidence of preterm labor (PTL) b. Delivery of an uncompromised infant c. Ensure future ability to conceive d. Prevention of HELLP syndrome e. Prevention of seizures
b,d,e
24. Which nursing intervention would be required in a patient receiving magnesium sulfate for preeclampsia? (Select all that apply.) a. Administer the loading dose as a bolus given by intravenous push (IVP). b. Continuously monitor vital signs and fetal monitor. c. Encourage patient to ambulate in room to prevent blood clots. d. Have calcium gluconate available at the bedside. e. Monitor deep tendon reflexes (DTRs).
b,d,e
30. Which substance is a type of laxative/cathartic? (Select all that apply.) a. Adsorbents b. Bulk-forming c. Emetics d. Emollients e. Stimulants
b,d,e
12. Which ophthalmic ointment is administered to the newborn immediately after birth? a. Bacitracin b. Erythromycin c. Gentamicin d. Penicillin
b.
14. A patient in preterm labor at 28 weeks is prescribed betamethasone 12 mg intramuscularly (IM) every 24 hours for 2 doses. The patient wants to know why she has to receive the drug. Which response would the nurse provide? a. "Betamethasone will stop your labor." b. "It will help the fetus' lungs mature more quickly." c. "It will promote closure of a patent ductus arteriosus." d. "This drug will promote fetal adrenal maturity."
b.
21. Which range of folic acid is the recommended daily allowance for during pregnancy? a. 100-400 mcg b. 400-800 mcg c. 800-1200 mcg d. 1200-1600 mcg
b.
23. An adult patient is scheduled to begin taking zidovudine 300 mg by mouth. Which time frame is zidovudine usually prescribed? a. Daily b. Every 12 hours c. Every 6 hours d. Every 8 hours
b.
24. An 8-week-old neonate has been diagnosed with human immunodeficiency virus (HIV) and will be receiving zidovudine orally. The child weighs 4.5 kg. Which dose would the nurse anticipate for this child? a. 9 mg/kg/dose bid b. 12 mg/kg/dose bid b. 12 mg/kg/dose bid c. 120 mg/kg/dose bid d. 300 mg/kg/dose bid
b.
24. The family planning nurse would be correct to tell a patient to stop taking her combined oral contraceptive and notify her health care provider if she experiences which alteration? a. Increased vaginal discharge b. Severe headaches c. Lighter/shorter periods d. Menstrual cramping
b.
32. The patient who is on several vitamins is taking mineral oil as a laxative. Which side effect would the nurse inform the patient could occur? a. Abdominal bloating and flatulence. b. Decreased absorption of fat-soluble vitamins A, D, E, and K. c. Dependence on the drug. d. Excessive fluid loss attributable to diarrhea.
b.
35. A nurse received an order for timolol 100 mg b.i.d. Which action would be most appropriate by the nurse? a. Give the patient the drug after proper identification. b. Hold the drug, and contact the health care provider regarding the dosage. c. Give the drug now, and request a new order during patient rounds. d. Assess the patient's vital signs, and give the drug.
b.
A patient with asthma asks the nurse how albuterol inhaler will work to help breathe better. Which response by the nurse best explains the action of the drug? a. "Albuterol will increase your heart rate so you will feel like you are able to breathe better." b. "Albuterol causes the airways to open up more in the lungs, improving function." c. "Albuterol will cause an increase in urinary output to remove extra fluid from the lungs." d. "Albuterol causes bronchial smooth muscle contraction that forces air into the lungs."
b.
13. A 16-year-old wrestler at a local high school tells the nurse during an annual sports physical that some of the athletes at the school use hormones to "bulk up" during the season. The patient wants to know if this is safe. Which response by the nurse is most correct? a. "A safer way to bulk up is to eat an all-protein diet." b. "As long as they don't use other street drugs, this is probably safe." c. "This can cause serious, often irreversible, health problems even years later." d. "This is a safe practice as long as a health care provider adjusts the dose."
c
15. Which statement describes the mechanism of action for bethanechol? a. Inhibits muscarinic receptors b. Inhibits nicotinic receptors c. Stimulates muscarinic receptors d. Stimulates nicotinic receptors
c
16. The patient's who was prescribed bethanechol asks the nurse how it works. Which response would be most appropriate by the nurse? a. "It decreases bladder tone." b. "It inhibits bladder contraction." c. "It promotes contraction of the bladder." d. "It stimulates urine production."
c
17. A pregnant patient with iron-deficiency anemia was prescribed ferrous sulfate 325 mg bid. Which laboratory value will show the first indication that the patient is responding to the iron supplement? a. Increased blood urea nitrogen b. Increased hemoglobin c. Increased reticulocyte count d. Increased international normalized ratio
c
19. A patient who works the night shift realized that she missed a dose of combined hormonal contraceptive (CHC). She calls the on-call nurse and asks what she should do. Which response would be most appropriate by the nurse? a. "It isn't a big deal. Just take one tomorrow." b. "Stop this pack and use alternative birth control for the next month." c. "Take your dose now, and then get back on schedule with the next one." d. "Take two now and use an alternative method of birth control."
c
24. Which value on the Bishop score is associated with the most successful labor induction? a. 5 b. 6 c. 8 d. 10
c
27. A patient who is taking high-dose nonsteroidal anti-inflammatory drug (NSAID) for arthritis is also taking sucralfate. Which laboratory value would concern the nurse? a. Hgb 14.1 gm/dL b. Potassium 4.2 mEq/L c. Blood glucose 185 mg/dL d. INR 1.1
c
A patient with narrow-angle glaucoma is prescribed an anticholinergic drug. Which action would be a priority by the nurse? a. Administer the medication as ordered after verifying the patient's identity. b. Give only one-half of the prescribed dose. c. Hold the dose and contact the health care provider. d. Wait until after the patient has taken glaucoma medication and then give the drug.
c
33. Beta1 receptors are located in which area of the body? (Select all that apply.) a. Gastrointestinal tract b. Lungs c. Kidneys d. Brain e. Heart
c,
29. The patient is complaining of labor pain due to the pressure of the presenting part and stretching of the perineum and vagina. This pain is experienced in which stage of labor? (Select all that apply.) a. First b. Latent c. Second d. Transition e. Third
c,d
35. The patient is experiencing diarrhea. Which food would the nurse advise the patient to avoid? (Select all that apply.) a. Bottled water b. Clear liquids c. Fried foods d. Milk products e. Gelatin
c,d
11. Which maternal physiologic change is seen during pregnancy that affects drug dosing? (Select all that apply.) a. Decreased urine output. b. Gastric motility is more rapid, resulting in faster absorption. c. Increased fluid volume. d. Increased glomerular filtration rate and rapid elimination of drugs. e. Increased liver metabolism of drugs.
c,d,e
22. Which drug class would the nurse know is most commonly used to treat gastroesophageal reflux disease (GERD)? (Select all that apply.) a. Antacids b. Anticholinergics c. Histamine2 blockers d. Pepsin inhibitors e. Proton pump inhibitors
c,e
A patient has been prescribed acyclovir. Which information would be part of the teaching plan for this patient? (Select all that apply.) a. Be sure to drink plenty of water to maintain hydration. b. Be sure to use spermicide to prevent infecting others. c. Drug can be taken at mealtime. d. Arise slowly because of the risk for orthostatic hypotension. e. Report any decreased urinary output, dizziness, or confusion.
c,e
17. Which individual would be contraindicated for oral contraceptives? a. 20-year-old who is not sexually active b. 40-year-old with diabetes c. 38-year-old with breast cancer d. 48-year-old with emphysema
c.
20. Which statement is correct on the goal of combination antiretroviral therapy (ART)? a. Decrease the viral load and decrease the CD4+ count. b. Decrease the CD4+ count and increase the viral load. c. Increase the CD4+ count and decrease the viral load. d. Replace the memory cells within the immune system.
c.
29. The nurse discovers an intravenous (IV) site has infiltrated on a patient receiving IV dopamine. The nurse prepares to administer which drug as an antidote. a. Dobutamine b. Epinephrine c. Phentolamine d. Reserpine
c.
7. A nurse is preparing to assist in administering beractant intratracheally. Which action is needed in preparing the drug? a. Warm for 5 seconds under hot running water. b. Shake the vial to mix the solution. c. Warm at room temperature for 20 minutes. d. Keep it refrigerated until immediately before administration.
c.
20. A patient asks the nurse when would be the best time to take an over-the-counter (OTC) antacid for "heartburn." Which time frame would the nurse provide? 1. 1 hour before meals 2. 1-3 hours after meals and at bedtime 3. With meals and at bedtime 4. With meals and 1 hour after
2.
26. A patient presents to the clinic with a swollen face and tongue, difficulty breathing, and audible wheezes after eating a peanut butter sandwich for lunch. Which action would the nurse first take? a. Ensure a patent airway. b. Obtain an electrocardiogram (ECG). c. Administer 1 mg of 1:1000 epinephrine subcutaneously. d. Start an intravenous (IV) normal saline.
A
