Pharmacology Learning System

RN is preparing to administer amoxicillin 250 mg liquid suspension PO q8h to older adult pt. Available is amoxicillin 50 mg/ml. How many ml should administer? (Round to nearest whole number)

5 mL

Nurse is providing teaching to parent of child who has asthma and new prescription for cromolyn sodium metered dose inhaler. Which of following statements by parents indicate need for further teaching? A. "I will give my child a dose as soon as wheezing starts." B. "My child should rinse out his mouth after using the inhaler." C. "My child should exhale completely before placing the inhaler in his mouth." D. "If my child has difficulty breathing in the dose, a spacer can be used."

"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.

Nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/ml. How many ml should nurse administer? (Round to nearest tenth)

0.5 mL

A nurse is preparing to administer heparin 8,000 units subq q8h. Available is heparin 10,000 units/ml. How many mL should nurse administer per dose? (Round to nearest tenth)

0.8 mL

Nurse is preparing to administer furosemide 4mg/kg/day PO divided into 2 equal doses daily to toddler who weighs 22 lbs. How many mg should nurse administer per dose? (Round to nearest whole number)

20 mg

Nurse is preparing to administer lactated Ringer's (LR) 1,000mL IV over 8hr. Drop factor of manual tubing is 10 gtt/ml. Nurse should set manual IV infusion to deliver how many gtt/min. (Round to nearest whole number)

21 gtt/min

Nurse is providing teaching to a group of new parents about meds. Nurse should include that aspirin is contraindicated for children who have viral infection d/t risk of developing which of following adverse effects? A. Reye's syndrome B. visual disturbance C. diabetes mellitus D. Wilms' tumor

A. 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.

Nurse is providing teaching to pt who has ulcerative colitis and new prescription for sulfasalazine. Nurse should instruct pt to monitor for which of following adverse effects of this med? A. jaundice B. constipation C. oral candidiasis D. sedation

A. jaundice 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.

Nurse is providing teaching to newly licensed nurse about administering morphine via IV bolus to pt. Which of following information should nurse include in teaching? A. respiratory depression can occur 7 min after the morphine is administered B. the morphine will peak in 10 min C. withhold the morphine if the client has a respiratory rate less than 16/min D. administer the morphine over 2 min

A. 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.

Nurse is caring for pt who is at 28 weeks of gestation and is experiencing preterm labor. Which following meds should nurse plan to administer? A. Oxytocin B. Nifedipine C. Dinoprostone D. Misoprostol

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

Nurse is caring for pt who has new prescription for enalapril. Nurse should monitor pt for which of following adverse effects of med? A. Ecchymosis B. Jaundice C. Hypotension D. Hypokalemia

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

Nurse is preparing to administer enteral tube feeding through NG tube at 250mL over 4hr. Nurse should set pump to deliver how many mL/hr? (Round to nearest whole number)

63 mL/hr

Nurse is administering subq heparin to pt who is at risk for deep vein thrombosis. Which of following actions should nurse take? A. Administer the medication into the client's abdomen. B. Inject the medication into a muscle. C. Massage the site after administering the medication. D. Use a 22-gauge needle to administer the medication.

A. Administer the medication into the client's abdomen. The heparin should be administered into the client's abdomen. The nurse should administer heparin using a 25-gauge or smaller needle to decrease the risk of hemorrhage.

Nurse is assessing pt who has new prescription for chlorpromazine to treat schizophrenia. Pt has mask-like facial expression and is experiencing involuntary movements and tremors. Which of following meds should nurse anticipate administering? A. Amantadine B. Bupropion C. Phenelzine D. Hydroxyzine

A. 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.

Nurse is caring for pt who has new prescription for tamoxifen. Nurse should recognize that tamoxifen has which of following therapeutic effects? A. Antiestrogenic B. Antimicrobial C. Androgenic D. Anti-inflammatory

A. 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 an increased risk.

Nurse is providing teaching to pt who has rheumatoid arthritis and prescription for long-term prednisone therapy. Nurse should instruct pt to monitor for which of following adverse effects? A. stress fractures B. orthostatic hypotension C. gingival ulcerations D. weight loss

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

Nurse is caring for pt who has been taking isoniazid and rifampin for 3 weeks for treat of active pulmonary TB. Pt reports his urine is orange color. Which of following statements should nurse make? A. "Stop taking the isoniazid for 3 days and the discoloration should go away." B. "Rifampin can turn body fluids orange." C. "I'll make an appointment for you to see the provider this afternoon." D. "Isoniazid can cause bladder irritation."

B. "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.

Nurse on medical unit is preparing to administer alendronate 40 mg PO for older adult pt who has Paget's disease of bone. Which of following actions should be nurse's priority? A. administer the medication to the client before breakfast in the morning B. ambulate the client to a chair prior to administering the medication C. give the medication to the client water rather than milk D. teach the client how to take the medication at home

B. 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.

Nurse is caring for pt who has new prescription for ergotamine. Nurse should recognize that ergotamine is administered to treat which of following conditions? A. Raynaud's phenomenon B. Migraine headaches C. Ulcerative colitis D. Anemia

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

Nurse is planning care for pt who has seizure disorder and new prescription for valporic acid. Which of following lab values should nurse plan to monitor? (Select all that apply) A. BUN B. PTT C. Aspartate aminotransferase (AST) D. Urinalysis E. Alanine aminotransferase (ALT)

B. PTT C. Asperate aminotransferase (AST) E. Alanine aminotransferase (ALT) Valproic acid can alter coagulation; therefore, PT and PTT should be monitored. Valproic acid can cause life-threatening hepatotoxicity. 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.

Nurse is reviewing lab values for pt who is receiving continuous IV heparin infusion and has aPTT of 90 secs. Which of following action should nurse prepare to take? A. Administer vitamin K B. Reduce the infusion rate C. Give the client a low-dose aspirin D. Request an INR

B. 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 newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? A. hyperthyroidism B. intestinal obstruction C. glaucoma D. low bp

B. 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.

Nurse is review lab results for pt who has prescription for filgrastim. Nurse should recognize that an increase in which of following values indicates therapeutic effect of this med? A. erythrocyte count B. neutrophil count C. lymphocyte count D. thrombocyte count

B. 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.

Nurse is assessing pt who is receiving IV gentamicin TID. Which of following findings indicate pt is experiencing adverse effects of med? A. hypoglycemia B. proteinuria C. nasal congestion D. visual disturbances

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

A nurse is caring for client who has new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is manifestation of which of following adverse effects? A. allergic response B. superinfection C. renal toxicity D. hepatotoxicity

B. 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.

Nurse is caring for older adult who has new prescription for amitriptyline to treat depression. Which of following diagnostic tests should nurse plan to perform prior to starting pt on this med? A. Hearing examination B. Glucose tolerance test C. Electrocardiogram D. Pulmonary function tests

C. 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.

Nurse is reviewing lab values for a pt who reports fatigue and cold intolerance. Pt has increased TSH level and decreased total T3 and T4 levels. Nurse should anticipate prescription for which following meds? A. Methimazole B. Somatropin C. Levothyroxin D. Propylthiouracil

C. 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.

Nurse is teaching newly licensed nurse about contraindications to ceftriaxone. Nurse should include severe allergy to which of following meds as contraindicated to ceftriaxone? A. Gentamicin B. Clindamycin C. Piperacillin D. Sulfamethoxazole-trimethoprim

C. 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.

Nurse is caring for pt who has prescription for clopidogrel. Nurse should monitor pt for which of following adverse effects? A. insomnia B. hyptension C. bleeding D. constipation

C. 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.

Nurse is teaching pt who has gout and new prescription for allopurinol. Nurse should instruct pt to d/c med for which of following adverse effects? A. nausea B. metallic taste C. fever D. drowsiness

C. 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.

Nurse is caring for pt who has prescription for cholorthiazide to Tx hypertension. Nurse should plan to monitor pt for which of following adverse effects? A. thrombophlebitis B. hyperactive reflexes C. muscle weakness D. hypoglycemia

C. 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 providing teaching to a client who has chronic kidney failure w/ AV fistula for hemodialysis and new prescription for epoetin alfa. Which of following therapeutic effect of epoetin alfa should nurse include in teaching? A. reduces blood pressure B. inhibits clotting of fistula C. promotes RBC production D. stimulates growth of neutrophils

C. 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.

Nurse is providing teaching to pt who has UTI and new prescriptions for phenazopyridine and ciprofloxacin. Which of following statements by pt indicates need for further teaching? A. "If the phenazopyridine upsets my stomach, I can take it with meals." B. "The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the infection." C. "I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin." D. "I should notify my provider immediately if my urine turns an orange color."

D. "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.

Nurse is providing teaching to pt who has new prescription for hydrochlorothiazide 50 mg PO to treat hypertension. Which of following instructions should nurse include in teaching? A. "Take hydrochlorothiazide as needed for edema." B. "Check your weight once each week." C. "Take the hydrochlorothiazide on an empty stomach." D. "Take the hydrochlorothiazide in the morning."

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

Nurse is caring for pt who has peptic ulcer disease and reports headache. Which of following meds should nurse plan to administer? A. Ibuprofen B. Naproxen C. Aspirin D. Acetaminophen

D. 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.

Nurse is caring for pt who has new prescription for amphotericin B. Nurse should plan to monitor pt for which of following adverse effects? A. Hyperkalemia B. Hypertension C. Constipation D. Nephrotoxicity

D. 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.

Nurse is administering subq epinephrine for pt who is experiencing anaphylaxis. Nurse should monitor pt for which of following adverse effects? A. Hypotension B. Hyperthermia C. Hypoglycemia D. Tachycardia

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

Nurse is caring for older adult pt who has new prescription for zolpidem at bedtime to promote sleep. Nurse should plan to monitor pt for which of following adverse effects? A. ecchymosis B. decreased urine output C. increased bp D. dizziness

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

Nurse is providing teaching to newly licensed nurse about caring for pt who has prescription for gemfibrozil. Nurse should instruct newly licensed nurse to monitor which of following lab tests? A. platelet count B. electrolyte levels C. thyroid function D. liver function

D. 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.

Nurse is providing teaching to pt who has cirrhosis and new prescription for lactulose. Nurse should instruct pt that lactulose has which of following therapeutic effects? A. increases bp B. prevents esophageal bleeding C. decreases HR D. reduces ammonia levels

D. 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.