Pharmacology

5. A nurse is planning to administer 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes. Identify the steps the nurse should take when preparing the two insulins in the selected order of performance. 1. Withdraw 20 units of air into the NPH insulin vial 2. Withdraw 10 units of air fr the regular insulin vial 3. inject 20 units of air into the NPH insulin vial 4. Inject 10 units of air into the regular insulin vial.

Answer 1, 3, 2, 4

2. A nurse is planning to instill eardrops to a toddler and must straighten the ear canal by pulling the auricle of the ear. The nurse should plan to pull the auricle in which of the following directions.? A. Down and backward B. Down and outward C. Upward and backward D. Upward and downward

Answer A

4. A nurse is caring for a client who is receiving Warfarin therapy to prevent a deep vein thrombosis. Which of the following medications should the nurse have available incase of an overdose? A. Epinephrine B. Atropine C. Protamine D. Vitamin K

Answer D

27. A nurse is reinforcing teaching with a female client who has rheumatoid arthritis and a prescription for methotrexate. which of the following information should the nurse include in the teaching? A. Take this medication at the same time each day B. Drink 10-12 glasses of water per day C. Take NSAIDs for generalized pain such as headaches D. Do not breastfeed within 2 hours of taking the medication.

B Methotrexate can cause renal toxicity, adequate hydration promotes the excretion and helps prevent this adverse effect

3. A nurse is planning to administer Ceftriaxone 3mL intramuscularly to an adult client. Which of the following actions should the nurse plan to take? A. Select a 5/8 inch needle B. Inject at 45 degree angle C. Choose a 25 gauge needle D. Locate the ventrogluteal site

Answer D When administering Ceftriaxone IM, it should be injected deeply into a large muscle, the syringe should be held at 90 degree angle, 1.5 inch needle for adults, 2 inch needle for obese adults and a 21 or 22 gauge should be used.

22. A nurse in an urgent care is collecting data from a client who reports taking an excessive amount of aspirin. which of the following findings should the nurse identify as an indication of salicylism? A. Tinnitus B. Joint pain C. Diuresis D. Respiratory Depression

Answer A Salicylism clinical manifestations are tinnitus, sweating, headache, dizziness and hyperventilation

26. A nurse is caring for a client who has herpes zoster, which of the four a toons should the nurse take? A. Apply sterile gauze dressing to affected areas B. Prepare to administer acyclovir C. Instruct family with a history of chicken pox that they should not visit the client D. Apply topical corticosteroids to the affected areas

Answer B Acyclovir is effective in treatment of herpes zoster especially if administered within 2-3 days of eruption.

23. A nurse is caring for a client who is taking Sumatriptan for migraine headaches and reports a positive pregnancy test. Which of the following responses should the nurse make? A. "You should discuss with your provider other migraine medications that are safe during pregnancy" B. " You should decrease your dose by one half when you are pregnant" C. " You should ask your provider for acetaminophen with codeine to take while you are pregnant"

Answer. A Sumatriptan is category C medication in pregnancy therefore the client should discuss the use of medication during pregnancy with the provider

16. A nurse is collecting data from a client who is taking Digoxin for heart failure. The nurse should instruct the client to avoid taking which of the following supplements? A. Feverfew B. St John's wort C. Echinacea D. Valerian

Answer. B Taking st Johns wort and digoxin can increase excretion of the medication and decrease it's effectiveness.

1. A nurse is reinforcing teaching with a young female adult client who has been prescribed Lisinopril. Which of the following instructions should the nurse plan to include? (SATA) A. Report the development of a persistent dry cough B. Monitor your blood pressure on a daily basis C. Notify your doctor immediately if you become pregnant D. Your cholesterol levels should be monitored monthly while taking the medication E. Make sure you consume a lot of potassium in your diet

Answer A, B, C The development of a dry persistent cough is a common problem with the use of ACE inhibitors. It is important to instruct the client to report that. Hypotension is a common side effect of Lisinopril so the client should be instructed on how to monitor their blood pressure on a regular basis. Lisinopril is a known teratogenic agent and may cause serious harm to a a developing fetus.

28. A nurse is reviewing the medical record of a client who has been taking simvastatin for 9 months. the client has an alanine aminotransferase ALT 120 units /L and aspartate aminotransferase AST 100 units/L which of the following data from the client's surgery history should the nurse report to the provider? A. The client drinks milk when taking the medication B. The client drinks grapefruit juice every evening C. The client eats spinach salad daily D. The client consumes a diet high in gluten

Answer B Grapefruit inhibits the drugs metabolizing enzyme CYP3A4 . client's taking grapefruit juice can experience medication toxicity leading to headaches, GI disturbances, and damage to muscles and liver.

8. A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription of Prednisone. Which of the following statements indicates understanding of the teaching? A. "I might notice a decrease in my blood sugar while taking this medication" B. " I should expect to feel hungry while taking this medication" C. I might have a fever while taking this medication" D. " I might be tired while taking this medication"

Answer B Prednisone might increase glucose levels, cause munosupression( fever should be reported to the PCP) and cause an increase in appetite.

18. A nurse is caring for a client who is scheduled for surgical repair of a femur fracture and has a prescription for lorazepam preoperatively. Which of the following statements by the client should indicate to the nurse that the medication has been effective? A. "My mouth is very dry" B. "I feel sleepy" C. "I am not hungry any longer" D. " My legs feel numb"

Answer B preoperative doses of benzodiazepines such as lorazepam relieve anxious and promote sedation.

22. A nurse is caring for a client who has asthma. The client asks the nurse how Albuterol helps his breathing. which of the fun instructions should the nurse include in her response? SATA A. The medication will increase the amount of mucus B. The . medication will prevent wheezing C. The medication will open the airways D. The medication will reduce inflammation E. The medication will decrease coughing episodes

Answer B, C, E

9. A nurse is reinforcing teaching with a client who is to start taking enteric coated naproxen for rheumatoid arthritis. Which of the following statements by the client indicates need for further teaching? A. "I am taking this kind of medication so that it dissolves in my intestine not my stomach" B. " It's okay to crush a tablet as long as I make sure it dissolves in water before I drink it" C. " I can take the tablet with meals"

Answer B. The client should not crush an enteric coated tablet.

10. A nurse mistakenly administers a dose of metformin within 1 hr of the previous dose. which of the following findings should alert the nurse the patient is experiencing an adverse effect from the medication error? A. Confusion and lethargy B. Rapid and deep respirations C. Diaphoresis and tachycardia D. Nausea and abdominal cramps

Answer C Diaphoresis and tachycardia are early manifestations of hypoglycemia. Confusion and lethargy are late manifestations of hypoglycemia the rest B and D are manifestations of hyperglycemia.

25. A nurse is caring for a client whose serum Potassium is 5.3 mEq/L. The nurse should anticipate prescription of which of the following medication? A. Potassium Chloride B. Acetylcysteine C. Sodium Polystyrene D. Potassium iodide

Answer C. In addition to calcium gluconate, glucose and insulin, sodium Polystyrene is administered orally to absorb excess potassium.

24. A nurse is reinforcing teaching with a client who has pulmonarytuberculosis and is to start taking rifampin. Which of the following information should the nurse include? A. Purified protein derivative skin test results will improve in 3 months B. Expect to have insomnia while taking this medication C. Take this medication with meals D. Urine and other secretions will turn orange

Answer D Rifampin will turn urine, sputum, tears, and sweat orange in color.

15. A nurse is reinforcing teaching with a client who is prescribed ferrous sulfate. Which of the following statements by the client indicates understanding of the teaching? A. "I will expect the color of my urine to be amber" B. " I will expect dark tarry stools" C." I will take extra care to protect against increased bruising" D. " I will not get as many infections"

Answer. B Ferrous sulfate is an iron supplement and an expected side effect of iron supplements is dark tarry stools.

19. A nurse is caring for a client who is postoperative and receiving fentanyl via patient controlled analgesia. The client client has a prescription for naloxone. The nurse should understand that the purpose of naloxone is? A. To suppress respiratory secretions B. Block the effects of opioids on the CNS C. To treat nausea D. To treat urinary retention

Answer. B Naloxone is a narcotic antagonist that prevents CNS and respiratory depression.

6. A nurse is caring for an old adult client who has a new prescription for Spironolactone. Which of the following laboratory values should the nurse monitor closely for this client? A. Hemoglobin B. Potassium C. Total cholesterol D Sodium

Answer. B Spironolactone is a Potassium sparring diuretic that can cause hyperkalemia. Spironolactone maybe discontinued if the Potassium level is above 5 mEq/L

12. A nurse is reinforcing teaching with a group of nurses about the administration of Nitroglycerin. Which of the following routes of administration provides the most rapid onset of for the client? A. Transdermal patch B. Sublingual C. Suspended release D. Topical Ointment

Answer. B Sublingual nitroglycerin has an onset of 1-3 mins, Transdermal has has an onset of 30-60 mins, Suspended release has an onset of 25-45 mins and topical has an onset of 30-60 mins.

11. A nurse is reinforcing teaching for a client who is about to start therapy with Alendronate to treat osteoporosis. For which of the following findings should the nurse instruct the client to monitor and report as an adverse effect of the medication? SATA A. Tinnitus B. Jaw pain C. Blurred Vision D. Drowsiness E. Dysphagia

Answer. B, C and E Alendronate can cause osteonecrosis of the jaw, ocular inflammation leading to blurred vision and esophagitis so the client should report any pain or difficulty swallowing.

20. A nurse is reinforcing discharge instructions for a client who has asthma and is about to start using beclomethasone MDI. For which of the following findings should the nurse instruct the client to monitor and report to the provider as an adverse effect of the medication? A. Tremors B. Nausea C. White coating in the mouth D. Dry oral mucus membranes

Answer. C Beclomethasone is an inhaled glucocorticoid and can cause oropharyngeal candidiasis. The client should gargle after use and report any white patches inside the mouth or on the tongue.

17. A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. which of the following statements by the adolescents parents is a priority for the nurse to address? A. " He only sleeps about 5 hours each night" B. " He takes his medication between meals with water" C. " He seems to be getting alot more bumps and bruises lately" D. " He has not been eating much lately"

Answer. C Carbamazepine can cause bone marrow suppression.

7. A nurse is caring for an older adult who has Parkinson's disease and is taking Selegiline 5 mg PO twice daily. which of the following therapeutic outcomes should the nurse monitor for with a client who is taking this medication? A. Improved speech patterns B. Increased bladder function C. Decreased tremors D. Diminished headaches

Answer. C Selegiline is a MOA-B inhibitor it improves motor function by decreasing tremors, rigidity and bradykinesia in a client who has Parkinson's disease.

14. A nurse is reinforcing teaching with a client who has a new prescription for apoetin Alfa. The nurse should reinforce the client to take the following dietary supplement with the medication. A. Vitamin D B. Vitamin A C. Iron D. Niacin

Answer. C Apoetin Alfa treats anemia by stimulating the production of red blood cells. Supplemental iron is needed for the production of hemoglobin and red blood cells by the bone marrow.

13. A nurse is collecting data from a client who has been taking Esomeprazole for several months. Which of the following statements should the nurse identify as indicating the effectiveness of the medication? A. "My feet are no longer sore and itchy" B. "I can move my joints more easily" D. "I don't have pain in my stomach anymore" E. " My bowel movements have increased in frequency and are much softer"

Answer. D Esomeprazole is a proton pump inhibitor that works by decreasing gastric acid secretion.

21. A nurse is reinforcing teaching with a client who has a new prescription for codeine. Which of the following information should the nurse include in the teaching? A. Take on an empty stomach to prevent nausea B. Limit alcohol intake to 12 oz daily. C. Diarrhea is an expected adverse effect D. Change positions slowly

Answer. D Codeine is an opioid analgesic that causes CNS depression and orthostatic hypotension. The client should change positions slowly to avoid risk of falls