Pharm Final Exam Practice Questions

A. "Oral forms of Vit B12 will not be absorbed."

A 50-yo female patient who has pernicious anemia asks you why Vit B12 must be administered parenterally. What is the best response to her question? A. "Oral forms of Vit B12 will not be absorbed." B. "Oral ingestion of Vit 12 causes irritation and bleeding" C. "Pernicious anemia causes changes in the mucous membrane lining and impairs absorption." D. "With severe deficiencies like yours, oral Vit 12 is not effective."

C. Frequent assessment of the client's cardiac status

A 55-yo man's hypertension has not responded adequately to his current medication regimen consisting of an ACE inhibitor, BB, and thiazide diuretic. As a result, he will soon begin taking hydralazine (Apresoline) in addition to his existing antihypertensives. The addition of this medication to his regimen means that the nurse must prioritize which nursing action? A. close monitoring of the client's electrolytes B. Supervision of the client when performing ADLs C. Frequent assessment of the client's cardiac status D. Checking the client's BG levels before each meal and at bedtime.

B. Heart rate D. Blood pressure

A client being treated in the hospital for a femoral fracture is scheduled to receive a daily dose of metoprolol that was prescribed 3 years ago. Prior to administering this drug, the nurse should assess and document which client data? (select all that apply). A. Oxygen saturation level B. Heart rate C. Potassium level D. Blood pressure E. Capillary refill

C. Decreased absorption

A client has had cholestyramine added to his or her treatment plan for dyslipidemia. What effect will Cholestyramine have on the pharmacokinetics of the thiazide diuretic that the client is currently prescribed? A. Increased first-pass effect B. Increased metabolism C. Decreased absorption D. Faster excretion

B. Pregnancy C. Serious hepatic disease E. Lactation

A nurse should be aware that use of stain drugs is contraindicated in clients with which conditions? (select all that apply.) A. Kidney disease B. Pregnancy C. Serious hepatic disease D. Carcinoma of the breast E. Lactation

D. The patient has chronic osteomyelitis resulting from a diabetic food ulcer.

A patient has been diagnosed with rheumatoid arthritis and is experiencing pain and is experiencing pain and decreased mobility. Entanercept has been proposed as possible treatment option. Which characteristic of this patient would likely prevent the use of entanercept? A. The patient is morbidly obese and leads and sedentary life style B. The patient uses a topical corticosteroid when he experienced contact dermatitis on his hands. C. The patient has a family history of cancer D. The patient has chronic osteomyelitis resulting from a diabetic food ulcer.

C. It causes decreased effectiveness of the antihypertensive drug.

A patient with muscle ache would like to use an OTC NSAID. The patient informs the nurse that he is taking antihypertensive drugs for blood pressure control. why should the nurse caution the patient against the use of an NSAID while on antihypertensive drugs therapy? A. It causes increased metabolism of the antihypertensive drug B. It causes increased absorption of the antihypertensive drug C. It causes decreased effectiveness of the antihypertensive drug. D. It causes decreased metabolism of NSAIDs.

A. Anorexia C. Constipation E. Dark Stools

After teaching a patient about the adverse effects of iron therapy, the patient demonstrates understanding of the information when the patient identifies what adverse effects? (select all that apply). A. Anorexia B. Dizziness C. Constipation D. Fatigue E. Dark Stools

A. Administration of acetlycystieine as prescribed.

An adult client has been admitted to the emergency department after deliberately overdosing on approximately 50 grams of Tylenol. The nurse should prepare for what intervention? A. Administration of acetlycystieine as prescribed. B. Watchful waiting C. Administration of Naloxone as prescribed D. Intravenous administration of LR

B. First-pass effect

The breakdown of oral drugs in the liver immediately after absorption is known as which of the following? A. distribution B. First-pass effect C. Enzyme induction D. Passive diffusion

A. INR (2-3) D. PT (25-35)

The client is receiving warfarin. Which would the nurse monitor to determine the effectiveness of therapy? (select all that apply). A. INR B. PTT C. HGB D. PT E. WBC

A. Assess the moisture level of the client's skin. C. Assess the client's recent bowel pattern. D. Assess the client's visual acuity.

The nurse is assessing a client for anticholinergic effects of a prescribed drug. What assessment should the nurse perform? (select all that apply) A. Assess the moisture level of the client's skin. B. Auscultate the client's breath sounds. C. Assess the client's recent bowel pattern. D. Assess the client's visual acuity. E. Assess the client's pupilary reflex

A. Assess the exact nature of the client's response to the drug.

The nurse is assessing a client new to the clinic. the client reports an allergy to Penicillin. What action should the nurse do next? A. Assess the exact nature of the client's response to the drug. B. Document that the client is allergic to Penicillin. C. Perform a comprehensive health assessment D. Continue to assess the client for other allergies.

C. Cardiac disease

When assessing a client who is to receive celecoxib, a history of which disease process or condition would be most important to assess? A. Peptic ulcers B. Diabetes C. Cardiac disease D. Respiratory disorder

B. Serum uric acid levels

When monitoring the efficacy of allopurinol therapy, the nurse should prioritize the results of what diagnostics test? A. Liver enzymes B. Serum uric acid levels C. Absolute neutrophil count D. C-reactive protein level (CRP)

D. Grapefruit

A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating: A. Cheese B. Chicken C. Corn D. Grapefruit

C. Safety measures

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. The need for follow-up blood tests B. The importance of a low-stimulation environment C. Safety measures D. Educating about the signs and symptoms of stroke.

B. BUN 45 C. Creatinine 3.7 D. Potassium 6.2 E. GFR 60 mL/min

A client is suspected to have nephrotocicity from administration of a nephrotoxic medication. What laboratory results may indicate renal damage related to the administration of this medication? (select all that apply). A. WBC 14,000 B. BUN 45 C. Creatinine 3.7 D. Potassium 6.2 E. GFR 60 mL/min

C. Immunizing agents are quite safe, and risks of the diseases they prevent are greater than the risks of vaccines.

A client is undergoing a yearly physical. While discussing immunizations, the client states not wanting any immunizations because they can cause diseases. The nurse's best response is: A. That was a long time ago; the new vaccines are completely safe. B. Vaccines are no longer made with live viruses, so she does not have to worry about being infected. C. Immunizing agents are quite safe, and risks of the diseases they prevent are greater than the risks of vaccines. D. Some vaccines are made from live viruses. Those vaccines can cause illnesses, but it is only used for clients with immunosuppression.

C. The client must wait until she has given birth before taking ergotamine. D. The client cannot safely take ergotamine until she has weaned her infant.

A client who is 14 weeks pregnant requests a prescription for ergotamine to help manage migraine headaches that have become increasingly more severe and frequent in recent months. How will this client's current health status affect the nurse's response to this request? (select all that apply) A. The client can safely use ergotamine but must be monitored for blood dyscrasias. B. The client must use a reduced dose of ergotamine until she has given birth C. The client must wait until she has given birth before taking ergotamine. D. The client cannot safely take ergotamine until she has weaned her infant.

B. Advise the client to avoid driving or operating machinery.

A client with seasonal allergies is taking an over the counter antihistamine to relieve itchy, watery eyes, and a runny nose. What intervention should the nurse provide for the client? A. Limit fluid intake to dry out mucous membranes. B. Advise the client to avoid driving or operating machinery. C. Warn of the possibility of insomnia D. Prevent the client from drinking grapefruit juice during treatment.

B. Serum drug level monitoring

A client, prescribed a drug that has an exceptionally narrow margin of safety, should be educated about the need for what intervention? A. Half-life analysis B. Serum drug level monitoring C. Regular changes to the administration route D. Frequent administration of scheduled "drug holiday"

D. "I use a lot of herbs and supplements, but I'm careful to make sure that they're all natural."

A gerontological nurse is conducting a medication assessment of a new client on a subacute medicine unit. Which of the client's statements should signal to the nurse a need for education? A. "Overall, I much prefer to prevent getting sick than having to rely on different drugs to stay healthy" B. "I've made a reminder system for myself so that I don't miss any of my pills during the day." C. "My family health care provider has me on so many different pills now, so I want to talk with her about whether they're all necessary." D. "I use a lot of herbs and supplements, but I'm careful to make sure that they're all natural."

A. Possible drug toxicity

A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for: A. Possible drug toxicity B. Decreased therapeutic effects C. Altered drug absorption D. Increased drug metabolism

A. "The HCP may need to increase the dosage of this medication." B. "It's really important that I have my blood tested on a regular basis." C. "Starting or stopping any of my other medications could cause me to bleed."

An older client has been prescribed an anticoagulant. What statement made by the client assures the nurse that the discharge information was understood correctly? (select all that apply). A. "The HCP may need to increase the dosage of this medication." B. "It's really important that I have my blood tested on a regular basis." C. "Starting or stopping any of my other medications could cause me to bleed." D. "This medication could damage my liver." E. "My kidneys could be injured by this medication."

A. The dosage of the first drug may have to be decreased.

How would the dosage of a partly protein-bound drug be altered if another drug having a higher attraction to albumin than the first drug is administered? A. The dosage of the first drug may have to be decreased. B. The dosage of both the first and the second drugs should be reduced equally. C. The dosage of the first drug may have to be increased. D. The dosage of the second drug may have to be increased.

C. Take the medication as soon as the earliest symptoms of migraine are sensed.

In order to maximize therapeutic benefit while reducing the risk of adverse effects of sumatriptan, the nurse should encourage the client to implement which intervention? A. Take the medication before breakfast each day B. Take the medication on days when migraines may be anticipated. C. Take the medication as soon as the earliest symptoms of migraine are sensed. D. Take the medication when the pain of a migraine becomes too much to bear.

A. Clients with uncontrolled HTN B. Clients needing an emergency transfusion E. Clients with a hypersensitivity to human albumin

The client is a woman, 69-yo, seen in the clinic for anemia and administration of epoetin alfa. Before giving the drug, the nurse takes a complete history and reviews the client's EMR, because the nurse knows that epoetin alfa is contraindicated for which conditions? (select all that apply). A. Clients with uncontrolled HTN B. Clients needing an emergency transfusion C. Clients with a recent infection D. Clients with exposure to anthrax E. Clients with a hypersensitivity to human albumin

A. Cumulative drug effects

The nurse administers a specific medication to an older adult client every 4 hours. The client has a history of chronic renal failure. The nurse should assess for indications of: A. Cumulative drug effects B. Drug-drug interactions C. Impaired absorption D. Drug tolerance

B. Kidney disease C. Liver disease D. Cardiac disease

The nurse administers an intravenous medication with a half-life of 24 hours. The nurse should recognize what factors in the client that could extend the drug's half-life? (select all that apply) A. gastrointestinal disease B. Kidney disease C. Liver disease D. Cardiac disease E. Route of administration

D. Distribution of the drug

The nurse has administered a drug that is known to be lipid soluble. This drug's solubility will primarily affect what aspect of pharmacokinetics? A. Absorption of the drug B. Metabolism of the drug C. Excretion of the drug D. Distribution of the drug

A. Use barrier contraceptives while taking benazepril to prevent pregnancy, as it may cause severe birth defects. C. If swelling of the face, throat, or extremities occurs, hold the next dose and call the primary care provider immediately. E. A dry cough may develop when taking Benazepril and it is not harmful, but if it is bothersome tell the primary care provider.

The nurse is caring for a 42-yo peri-menopausal client recently diagnosed with hypertension and prescribed Benazepril. The client also takes OTC ibuprofen for headaches. The nurse would provide which important points when educating the client on taking the new medication? (select all that apply). A. Use barrier contraceptives while taking benazepril to prevent pregnancy, as it may cause severe birth defects. B. Take the medication one hour before meals or 2 hours after meals to enhance absorption of antihypertensives. C. If swelling of the face, throat, or extremities occurs, hold the next dose and call the primary care provider immediately. D. Taking ibuprofen can make the drug more potent and decrease your blood pressure more, so take acetaminophen instead. E. A dry cough may develop when taking Benazepril and it is not harmful, but if it is bothersome tell the primary care provider.

D. Hold the dose and contact the provider.

The nurse is caring for a 76-yo client who is receiving IV Heparin 5000 units Q4H. At the initiation of therapy, the client's control activated throboplastin time (APTT) was found to be 35 seconds. One hour prior to the next scheduled dose, APTT is determined to be 92 seconds. Based on this result, the nurse will: A. Administer an increased dose at the scheduled time B. Administer the scheduled dose C. Administer the scheduled dose and monitor the client closely. D. Hold the dose and contact the provider.

A. The client's skin and eyes are visibly jaundiced. B. The client's AST and ALT levels are elevated. D. The client has multiple bruises and petechia.

The nurse is caring for a client who has been admitted after an acetaminophen overdosage. Which of the nurse's assessment findings suggest liver damage? (select all that apply) A. The client's skin and eyes are visibly jaundiced. B. The client's AST and ALT levels are elevated. C. The client's eyes are sensitive to light. D. The client has multiple bruises and petechia.

C. Potassium levels

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. cognition B. Liver enzyme levels C. Potassium levels D. Renal function

D. Confusion and lack of coordination.

The nurse is providing care for a client whose type 2 diabetes is treated with glipizide when monitoring the client for potential adverse effects, the nurse would assess for: A. increased urine output B. Deep kussmaul respirations C. Thirst and hot, flushed skin D. Confusion and lack of coordination.

C. 64 seconds

The nurse is reviewing the coagulation studies of a client who is receiving a heparin infusion. The client's baseline partial thromboplastin time is 32 seconds. Which result would indicate therapeutic effectivenesss? A. 32 seconds B. 40 seconds C. 64 seconds D. 96 seconds

A. Take a laxative/stool softener C. Rise slowly from a sitting or lying position D. Do not drive or make important decisions

The nurse is reviewing the discharge instruction with the client going home on an opioid analgesic for pain management. What would the nurse include in the instructions? (select all that apply) A. Take a laxative/stool softener B. Limit fluid intake C. Rise slowly from a sitting or lying position D. Do not drive or make important decisions E. Increase sodium intake

A. Be consistent with our intake of foods containing Vit K. B. Do not change brands of warfarin without consulting the health care provider. C. Take the drug at the same time every evening. D. Do not take or stop taking other medications except on the advise of the health care provider.

The nurse is teaching a client and caregiver about the warfarin which has been prescribed to continue at home. The nurse determines the teaching session is successful when the client and caregiver correctly choose which instructions to follow? (select all that apply). A. Be consistent with our intake of foods containing Vit K. B. Do not change brands of warfarin without consulting the health care provider. C. Take the drug at the same time every evening. D. Do not take or stop taking other medications except on the advise of the health care provider. E. Use prescribed antibiotics to prevent infection

D. A 29-yo client receiving prenatal care in her first trimester of pregnancy E. A 37-yo client who is taking fertility drugs

The nurse should consider teratogenic effects when caring for what clients? (select all that apply) A. An 88-yo client with chronic heart failure and peripheral edema B. A 51-yo client who is immunocompromised following bone marrow transplant C. A 54-yo client being treated in the intensive care unit for multi-organ dysfunction syndrome D. A 29-yo client receiving prenatal care in her first trimester of pregnancy E. A 37-yo client who is taking fertility drugs

A. Decreased renal blood flow B. Decreased glomerular function D. Decreased Tubular secretion

The nurse understands that normal age-related changes occur with drug administration, and drugs that are excreted by the kidney may have to be given in smaller doses. What are the normal age-related changes in excretion of drugs? (select all that apply) A. Decreased renal blood flow B. Decreased glomerular function C. Decreased hepatic blood flow D. Decreased Tubular secretion E. Decreased Serum Albumin

B. Decreased blood flow C. Decreased absorption surface D. Decreased gastrointestinal (GI) motility E. Increased gastric pH

The nurse understands that when administering drug therapy to older clients there are normal age-related absorption changes. How is absorption affected in the older client? Select all that apply. A. Deceased glomerular function B. Decreased blood flow C. Decreased absorption surface D. Decreased gastrointestinal (GI) motility E. Increased gastric pH

A. AST and ALT levels

The nurse's assessment of a client reveals that the client has been greatly exceeding recommended safe doses of acetaminophen for the past week. When reviewing the client's laboratory results for indications of toxicity, what finding should the nurse prioritize? A. AST and ALT levels B. BUN, creatinine, and potassium C. White cell count and white cell diffrential D. C-reactive protein level and platelet count.

C. Sulfonamide allergy

What assessment should the nurse make before administering the first dose of Hydrocholorthiazide? A.Pulse rate B. Hemoglobin level C. Sulfonamide allergy D. Neutrophil level

C. Vital signs

What is a priority nursing assessment of a client prescribed oral sumatriptan? A. Urinary output B. Head to toe assessment C. Vital signs D. Glasgow coma scale

C. Gynecomastia

When preparing the teaching plan for a male client who is prescribed Spironolactone, the nurse would alert the client to the possibility of which of the following? A. Erectile dysfunction B. Pripism C. Gynecomastia D. Alopecia

B. Have a long duration of action.

When researching information about a drug, the nurse finds that the drug tightly binds to protein. The nurse would interpret this to mean that the drug will: A. Be released fairly quickly. B. Have a long duration of action. C. Be excreted quickly. D. Lead to toxicity when given.

A. The drug is lipid soluble B. The drug has a transport system

Which characteristics may allow a drug to cross the blood-brain barrier? Select all that apply. A. The drug is lipid soluble B. The drug has a transport system C. The drug is available for intravenous administration D. The drug is metabolized by the central nervous system (CNS)

A. Assess laboratory values B. Obtain blood pressure C. Review allergy history D. Discuss lifestyle changes

Which nursing interventions should a nurse specifically perform for a client prescribed Lostartan? (select all that apply). A. Assess laboratory values B. Obtain blood pressure C. Review allergy history D. Discuss lifestyle changes E. Keep HOB elevated F. Review family history for seizures

B. Heparin

the nurse is preparing to administer protamine emergently to a client per instructions from the health care provider. The nurse concludes this is necessary due to an adverse reaction to which drug? A. Clopidogrel B. Heparin C. Alteplase D. Warfarin