RN Pharmacology Online Practice 2023 B (Fall)

A nurse is providing education to a patient who is to begin taking risperidone for the management of schizophrenia. Which instruction should the nurse include in the patient education?

"Add extra snacks to your diet to prevent weight loss." "You may begin to have mild seizures while taking this medication." "Notify the provider if you have trouble sleeping." "This medication is likely to increase your libido." C

A nurse is providing education to a patient who will be started on lithium for management of bipolar disorder. Which statement by the patient demonstrates an understanding of the education?

"I cannot take this medication if I become pregnant." "I will need to have my blood levels checked once a year." "Long-term treatment can make my thyroid work more." "This medication helps with my depression only." A

A nurse is providing instructions to a patient who has a new prescription for inhaled albuterol as needed for shortness of breath. Which instruction should the nurse include in the patient education?

"This medication can slow skeletal growth rate." "Prolonged use can increase your blood sugar." "Watch for tremors while on this medication." "Take this scheduled medication every six hours." C

A nurse is providing discharge teaching to a patient who has a new prescription for fluoxetine for post-traumatic stress disorder. Which statement should the nurse include in the teaching?

"You should take this medication at bedtime to help promote sleep." "You can have a decreased desire for intimacy while taking this medication." "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication." "You will have fewer urinary adverse effects if you urinate just before taking this medication." B

A nurse is providing education for a patient with attention deficit-hyperactivity disorder who will be started on guanfacine. The nurse correctly instructs the patient to monitor for which medication-related adverse effect?

"watch for drowsiness, especially with activities requiring alertness"

A nurse is caring for a patient currently on methotrexate for the treatment of non-Hodgkin's lymphoma. The nurse is reviewing the patient's labs and notes that the patient's uric acid level is elevated. The nurse correctly anticipates which orders?

Intravenous ibuprofen and fluid restriction. Subcutaneous insulin and glucose monitoring. Intramuscular epinephrine and telemetry monitoring. Oral allopurinol and increased fluid intake. D

A nurse is caring for a patient currently on levodopa/carbidopa for the management of Parkinson's disease. The nurse understands that therapeutic effects with the medication are due to:

Monoamine oxidase promotion. Dopamine receptor antagonism. Increased dopamine synthesis. Catecholamine-0-methyltransferase promotion. C

A nurse is caring for a patient who has been on long-term treatment with esomeprazole. Upon assessment, which finding would be of most concern for a medication-related adverse effect?

Negative rebound tenderness upon palpation. Percussion of tympanic abdominal sounds. Flat abdominal contour upon inspection. Auscultation of bibasilar crackles. D

A nurse is caring for a patient who will be starting varenicline for management of abstinence from nicotine. The nurse understands that therapeutic effects with the medication are due to:

Nicotinic agonism promoting the release of dopamine. Muscarinic antagonism preventing the release of acetylcholine. Muscarinic agonism promoting the release of acetylcholine. Nicotinic antagonism preventing the release of dopamine. A

A nurse is caring for a patient who is receiving bupropion as part of their treatment for depression. The nurse understands that therapeutic effects with the medication are due to:

Norepinephrine and dopamine reuptake inhibition. Serotonin and norepinephrine reuptake inhibition. Norepinephrine and dopamine antagonism. Serotonin and norepinephrine antagonism. A

A nurse is caring for a patient currently on leuprolide for the treatment of prostate cancer. The nurse is providing education to the patient on changes in bone density. The nurse correctly instructs the patient to perform which action while on the medication?

Perform weight-bearing exercises. Maintain bedrest and limit activity. Restrict vitamin D supplementation. Avoid intake of dairy products in diet. A

A nurse is caring for a patient currently on chlorpromazine for the management of schizophrenia. Upon assessment, the nurse notes that the patient has spasms of the tongue, neck, and face. Which action by the nurse is the most appropriate?

Place the patient on continuous telemetry. Administer intravenous diphenhydramine. Implement a 1000 mL fluid restriction. Position the patient in Trendelenburg. B

A nurse is caring for a patient currently on cyclophosphamide for the treatment of multiple myeloma. The nurse is reviewing the patient's most recent urine diagnostics. Which finding is of most concern for a medication-related adverse effect?

Positive for hematuria. Negative for glycosuria. Specific gravity 1.010. Negative for proteinuria. A

A nurse is reviewing the use of mood-stabilizing anti-epileptics for the maintenance treatment of bipolar disorder with a nursing student. The nurse correctly states that therapeutic effects are achieved with the medications except:

Potentiate the inhibitory effects of gamma butyric acid. Slow the entrance of calcium back into the neuron. Inhibit glutamic acid to suppress central nervous system excitation. Accelerate the entrance of sodium back into the neuron. D

A nurse is reviewing laboratory findings notes that a patient's lithium level is 2.1 mEq/L. Which is the most appropriate action by the nurse?

Prepare the patient for hemodialysis. Administer an additional oral dose of lithium. Perform immediate gastric lavage. Administer the scheduled dose as prescribed. C normal levels just to know are 0.6-1.2

A nurse is caring for a patient who has been on metformin for management of type II diabetes mellitus. Upon assessment, the nurse notes the patient has hyperventilation and sluggishness. The nurse understands the best action is to:

Prepare the patient for hemodialysis. Position the patient in Trendelenburg. Obtain a complete blood count. Administer intravenous naloxone. A

A nurse is caring for a patient who is currently on phenobarbital for the management of epilepsy. When reviewing the medication administration record, the nurse is most concerned of medication interaction-related CNS depression with which other medication?

Proton pump inhibitor. Opioid agonist analgesic. Beta-1 receptor antagonist. Angiotensin II receptor blocker. B

A nurse is caring for a patient who is receiving oral aspirin for prevention of reinfarction following an acute myocardial infarction. Upon assessment, the nurse notes that the patient is having increased difficulty with hearing. The nurse understands the most appropriate action is to perform which?

Request a route change to intravenous. Withhold the dose and notify the provider. Administer drops into the affected ear(s). Co-administer with a NSAID. B

A nurse is caring for patient who recently started a selective serotonin reuptake inhibitor as part of their management for bipolar disorder. Upon assessment, the nurse notes that the patient appears diaphoretic with a heart rate of 114 and an oral temperature of 101.9 F. Which action by the nurse is considered best?

Change medication to a SNRI. Administer antihistamine as needed. Administer the SSRI as ordered. Start symptomatic treatment. D

A nurse is monitoring a patient who has been on ezetimibe as part of their management of hyperlipidemia. Which assessment finding would be of most concern for a medication-related adverse effect?

Costovertebral pain. Suprapubic pain. Right upper quadrant pain. Left lower quadrant pain. C

A nurse is providing education to a patient who will be starting amitriptyline for the management of depressive episodes of bipolar disorder. The nurse instructs the patient to monitor for anticholinergic effects. The nurse correctly instructs the patient to watch for:

Dry mouth. Diarrhea. Urinary frequency. Decreased heart rate. A

A nurse is monitoring a patient who is on enoxaparin for post-operative prophylaxis of deep vein thrombosis. The nurse understands that prevention with the medication is directly due to which mechanism?

Inactivation of factor Xa. Antagonism of vitamin K. Inhibition of antithrombin. Cyclooxygenase inhibition. A

A nurse is providing education to a patient who will be started on sucralfate as part of their treatment for acute duodenal ulcers. The nurse instructs the patient to do what to limit medication-related adverse effects?

Increase consumption of daily citrus. Implement a daily fluid restriction of 1000 mL. Limit daily exercise and maintain bedrest. Elevate intake of whole grains in their diet. D

A nurse is caring for a patient who is receiving filgrastim prior to an autologous transplant. The nurse understands that the expected action with administration of the medication is:

Increase in hemoglobin & hematocrit. Increase in red blood cell count. Increase in thrombocyte count. Increase in white blood cell count. D

A nurse is providing information to a patient with early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the patient to monitor for which medication-related adverse effect?

Increased salivation. Diarrhea. Hallucinations. Discoloration of urine. C

A nurse is caring for a patient with attention deficit-hyperactivity disorder who will be started on methylphenidate. The nurse understands that therapeutic effects with the medication are achieved via which mechanism?

Increasing levels of serotonin in the central nervous system. Decreasing levels of acetylcholine in the peripheral nervous system. Increasing levels of norepinephrine in the central nervous system. Decreasing levels of dopamine in the peripheral nervous system. C

A nurse working in an emergency department is caring for a patient with manifestations of toxicity after taking multiple doses of a benzodiazepine. Which action is the nurse's priority?

Infuse intravenous fluids. Prepare the patient for gastric lavage. Identify the patient's level of orientation. Administer flumazenil. C

A nurse is caring for a patient who will be starting nicotine lozenges as part of nicotine replacement therapy for former tobacco use. The nurse instructs the patient the patient to:

Allow to slowly dissolve in the mouth over 20-30 minutes. Crush the medication and mix with 8 ounces of water. Take the medication by mouth and swallow whole. Chew the medication and take with 8 ounces of water. A

A nurse is caring for a patient who is currently receiving lorazepam who management of alcohol withdrawal. The nurse understands that the combination of lorazepam and which other medication class would most increase the risk of central nervous system depression?

Angiotensin converting enzyme inhibitors. Histamine-2 receptor antagonists. Beta-1 adrenergic agonist medications. Opioid agonist analgesic medication. D

A nurse is caring for a patient who is receiving disulfiram for abstinence maintenance following alcohol withdrawal. The nurse correctly instructs the patient to:

Avoid alcohol while on the medication. Limit alcohol consumption to five drinks weekly. Use hand sanitizer when performing hygiene. Take the medication by mouth as needed. A

A nurse is caring for a patient who will be starting nasal triamcinolone for the management of allergic rhinitis symptoms. The nurse correctly instructs the patient to do what with medication administration?

Take for no longer than 3 days in total. Administer the medication daily. Administer the medication as needed. Continue using if nosebleed occurs. B

A nurse is caring for a patient that will be started on levothyroxine for the management of hypothyroidism. The nurse correctly instructs the patient to do which with administration of the medication?

Take on an empty stomach before breakfast. Take by mouth every twelve hours. Take at bedtime with a full glass of water. Take three times daily with meals. A

A nurse is caring for a patient currently on chlordiazepoxide for the management of alcohol withdrawal. The nurse understands that the goal of the medication therapy is to:

decrease the patient's risk of a seizure.

A nurse is caring for a patient currently on propylthiouracil for the treatment of Graves' disease. The nurse understands that which assessment finding is of most concern for overmedication?

heart rate of 48 bpm

A nurse is caring for a patient who will be started on paroxetine as part of their management of obsessive-compulsive disorder. The nurse correctly instructs the patient to administer the medication:

in the morning

A nurse is providing education to a patient with exercise-induced bronchospasm that will be started on montelukast. The nurse understands that therapeutic effects with the medication are due to which action of the medication?

suppression of leukotriene activity

A nurse is caring for a patient who is on guaifenesin for symptomatic management of a cough caused by a lower respiratory disorder. The nurse understands that the expected direct action of administration of the medication is:

thinning of mucous secretions

a nurse is preparing to administer an IV fluid bolus of 200mL dextrose 5% in water over 30 mins. drop factor is 15gtt/mL

100gtt/min

a nurse is preparing to administer 0.45% sodium chloride 1000mL to infuse over 8 hr...

125ml/hr

A nurse is caring for a patient currently on olanzapine for the management of psychotic episodes induced by levodopa therapy. The nurse understands that therapeutic effects with olanzapine are primarily due to:

Activation of acetylcholine. Blocking of serotonin. Activation of histamine. Blocking of epinephrine. B

A nurse is caring for a patient who was recently started on pravastatin for the management of hypercholesterolemia. The patient reports that they have new-onset muscle pain and aches. The nurse understands that the best action is:

Administer the medication as scheduled. Obtain an additional oral dose. Obtain a serum creatine kinase level. Continue to monitor the patient. C

A nurse is caring for a patient who has been on codeine for suppression of cough from a respiratory infection. Upon assessment, the nurse notes the patient's respiratory rate is 7 and breathing is shallow. The nurse understands to perform which action next?

Administer the scheduled codeine. Administer intravenous flumazenil. Administer intravenous naloxone. Continue to monitor the patient. C

A nurse is caring for a patient who is on pregabalin for the treatment of neuropathic pain. Upon assessment, the nurse notes swelling around the patient's lips and tongue. The nurse understands that the most appropriate action to take next is:

Administer the scheduled dose as prescribed. Discontinue the medication. Co-administer with a proton pump inhibitor. Inquire about an additional oral dose. B

A nurse is caring for a patient who is currently on doxorubicin for the treatment of soft tissue sarcoma. Upon assessment, the nurse notes that the patient has a red coloration to their urine. The nurse understands that the best action is to:

Administer trimethoprim-sulfamethoxazole. Insert a urinary catheter. Continue to monitor. Obtain a 24-hour urine collection. C

A nurse is caring for a patient that will be on oral prednisone therapy following an acute asthma episode. The nurse understands to monitor the patient for which direct medication-related adverse effect?

Adrenal gland suppression. Increased pituitary gland activity. Increased adrenal gland activity. Pituitary gland suppression. A

A nurse is caring for a patient who is currently on vincristine for the treatment of acute lymphocytic leukemia. The nurse understands that treatment of the malignancy is due to:

Antagonism of androgen hormones. Stopping of cell division during the M-phase. Folic acid conversion inhibition. Inhibition of topoisomerase II activity. B

A nurse is caring for a patient who is currently receiving ondansetron for the management of chemotherapy induced nausea and vomiting. The nurse understands that emesis prevention is due to which mechanism of the medication?

Antagonism of serotonin receptors. Blockade of dopamine receptors. Antagonism of muscarinic receptors. Blockade of histaminergic receptors. A

A nurse is caring for a patient currently on cetuximab infusions for the treatment of a malignancy. The nurse understands to perform which action prior to the administration of the medication?

Begin to monitor for elevations in blood pressure. Obtain a serum medication trough level. Insertion of a Foley urinary catheter. Premedication with diphenhydramine. D

A nurse is caring for a patient currently on anastrazole for the treatment of breast cancer. The nurse understands that treatment of the malignancy is directly due to which action of the medication?

Blocking of estrogen receptors. Antagonism of androgen receptors. Agonism of gonadotropin-release hormone. Inhibition of aromatase. D

A nurse is reviewing a patient's medication list as part of their admission to a medical-surgical unit. The nurse notes that the patient is taking buspirone for the management of panic disorder. When reviewing the patient's intake of herbal preparations, which would be of most concern for an interaction with buspirone?

Chamomile. Garlic. St. John's wort. Echinacea. C

A nurse is caring for a patient who is currently on oprelvekin while undergoing chemotherapy. The nurse understands that the administration of the medication is to:

Decrease risk of pancytopenia. Decrease risk of neutropenia. Decrease risk of thrombocytopenia. Decrease risk of anemia. C

A nurse is educating the patient on the use of a first-generation antihistamine medication for the management of allergy symptoms. The nurse correctly states it would be most important for the patient to avoid which while on the medication?

Dairy. Alcohol. Caffeine. Protein. B

A nurse is in the post-anesthesia recovery unit and is caring for a patient who received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should expect a prescription for which medication?

Dantrolene. Neostigmine. Vecuronium. Naloxone. B

A nurse is caring for a patient who will be started on carbamazepine for the management of seizures. The nurse understands that monitoring of which blood test is most important while the patient is on the medication?

Hemoglobin A1c. Complete blood count. Lipid panel. Thyroid panel. B

A nurse is caring for a patient currently on topotecan for the treatment of metastatic colorectal cancer. The nurse correctly states in the patient education that monitoring of which blood test is most important while on the medication?

Hepatic function. Renal function. Complete blood count. Thyroid panel. C

A nurse is caring for a patient who will be starting sertraline for the management of major depressive disorder. The nurse correctly educates to the patient that therapeutic effects should be expected after which time frame?

Up to three days. Up to four weeks. Up to one week. After the first dose. B

A nurse is caring for a patient currently on metoclopramide for management of diabetic gastroparesis. Which finding upon assessment is of most concern for a medication-related adverse effect?

Urinary retention and dry mucous membranes. Polydipsia and elevated bedside blood glucose. Repetitive, involuntary movements in the upper extremities. Prolonged QT interval upon inspection of telemetry. C

A nurse is providing education to a patient who is on an inhaled glucocorticoid for the management of chronic asthma. The nurse correctly instructs the patient to perform which action with medication administration?

Use as needed for acute shortness of breath. Rinse mouth with water after administration. Administer while on an empty stomach. Administer the medication while exhaling. B

A nurse is monitoring a patient currently on a basal and bolus insulin regimen. Upon assessment, the patient is noted to feel lightheaded with a blood glucose of 45. Which action by the nurse is considered most appropriate?

administer oral glucose

A nurse is providing education to a patient who will be started on a monoamine oxidase inhibitor for the management of generalized anxiety disorder. The nurse will be discussing nutritional choices while on the medication. The nurse correctly instructs the patient to avoid which while on the medication?

aged cheese