Pharmacology ATI Capstone Pre Test

A nurse have provided education to a client regarding prescribed levothyroxene sodium. What of the following client statements demonstrates understanding of medication administration? Select one: a. "I should take my medication as needed to alleviate symptoms." b. "I should take the medication on a full stomach." c. "I should take the medication in the morning to prevent insomnia." d. "I should take the medication in divided doses to ensure therapeutic drug levels."

"I should take the medication in the morning to prevent insomnia."

A nurse is preparing to administer morphine sulfate 2 mg IV bolus. Available is morphine sulfate 10 mg/mL. How many mL should the nurse administer per dose?

0.2 mL

A nurse is administering 15,000 units of subcutaneous heparin. The amount available is heparin injection 30,000 units/mL. How many milliliters should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero). Select one: a. 0.4 mL b. 0.5 mL c. 1.0 mL d. 2.0 mL

0.5 mL

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow?

1. Inspect vials for contaminants 2. Roll NPH vial between palms of hands 3. Inject air in to the NPH insulin vial 4. Inject air into the regular insulin vial 5. Withdraw short-acting insulin into syringe 6. Add intermediate insulin to syringe

A nurse is caring for a client who has diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

42 units Each order of for units of insulin is combined in the same syringe. The nurse should withdraw the regular insulin into the syringe first.

A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site? Select one: a. a 75 degree angle b. a 60 degree angle c. A 90 degree angle d. a 45 degree angle

A 90 degree angle IM injections should be administered at a 90 degree angle.

Methotrexate blood levels are monitored to determine therapeutic dosing. The nurse knows that high-dose levels of methotrexate therapy can lead to __________ damage. Select one: a. liver b. retinal c. connective tissue d. neurologic

Acetaminophen, methotrexate, tetracyclines, and tamoxifen increase levels of mipomersen and can increase risk for liver damage. The correct answer is: liver

A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication? Select one: a. Avoid dairy products while taking this medication. b. Advise client to take the medication once daily at bedtime. c. This medication is for acute management of asthma. d. If the client forgets to take the medication for a few days he can double up on doses to catch up.

Advise client to take the medication once daily at bedtime.

A client with osteoporosis is prescribed alendronate. What client education should the nurse provide to ensure optimal absorption of the medication? Select one: a. Advise the client to take the medication with no more than 4 oz of water. b. Advise the client to take the medication with a glass of milk. c. Advise the client to take the medication with grapefruit juice. d. Advise the client to take the medication on an empty stomach with at least 8 oz of water.

Advise the client to take the medication on an empty stomach with at least 8 oz of water.

Drug Class for terazosin

Alpha-Adrenergic blocker

Drug Class for captopril

Angiotensin Converting enzyme (ACE) inhibitor

A client prescribed the tricyclic antidepressant, amitriptyline has been on the medication for three weeks. The client vocalizes increased mood, but complains of anticholinergic effects. What is an example of an anticholingeric adverse effect? Select one: a. Anxiety b. Urinary retention c. Orthostatic hypotension d. Sedation

Anticholinergic effects include dry mouth, blurred vision, photophobia, urinary retention, constipation and tachycardia. Orthostatic hypotension, sedation and anxiety are not associated with anticholingeric effects. The correct answer is: Urinary retention

Drug Class for amiodarone

Antidysrhythmic agent

Drug Class for atenolol

Beta Adrenergic Blocker

classifications of diuretics to their mechanism of action Potassium-sparing diuretics

Block the action of aldosterone (sodium and water retention) which result in potassium retention and the secretion of sodium and water

Drug Class for clonidine

Centrally acting alpha-2 agonist

A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse take when administering this medication? Select one: a. Do not expel the air bubble from the prefilled syringe b. Aspirate prior to administration c. Administer the medication via shallow subcutaneous injection in the deltoid muscle d. Carefully rub the injection site after administration

Do not expel the air bubble from the prefilled syringe

A nurse is to instill ear drops to a 2 year-old child. To straighten the ear canal, the nurse should pull the auricle of the ear: Select one: a. Upward and outward b. Upward and backward c. Down and outward d. Down and backward

Down and backward

Drug Class for ciprofloxacin

Fluroquinolone

Drug Class for ondansetron

Fluroquinolone

Drug Class for prednisone

Glucocorticoid

A client with peptic ulcer disease takes cimetidine. Which of the below outcomes can occur if H2-receptor antagonists, such as cimetidine are taken long term? Select one: a. Hyperkalemia b. Pneumonia c. Paralytic Ileus d. Fluid Retention

H2-receptor antagonists decrease gastric acidity, which promotes bacterial colonization of the stomach and the respiratory tract, which can lead to the outcome of pneumonia. Paralytic Ileus, fluid retention, and hyperkalemia are not expected outcomes with long term use of H2-receptor antagonists. The correct answer is: Pneumonia

Antidote Protamine sulfate

Heparin

Disulfiram is taken by a client daily for abstinence maintenance. What is an adverse effect of this therapy? Select one: a. Diarrhea b. Wernicke's aphasia c. Suicidal ideations d. Hepatoxicity

Hepatoxicity is an adverse effect of disulfiram. Wernicke's aphasia, suicidal ideations and diarrhea are not associated with this therapy. The correct answer is: Hepatoxicity

A nurse is providing care to a client with staphylococcus epidermidis, who is prescribed vancomycin. Identify the adverse effect associate with this antibiotic therapy? Select one: a. Hepatotoxicity b. Infusion reaction c. Constipation d. Immunosuppression

Infusion reaction Red Man Syndrome or an infusion reaction that results in rashes, flushing, tachycardia and hypotension can occur as an adverse reaction. For this reason, vancomycin should be administered over a 60 minute period.

A client taking lithium should be cautioned about drug interactions with which below medication? Select one: a. Warfarin b. Fluoxetine c. St. John's Wart d. Nifedipine

Lithium and fluoxetine drug-drug interaction can lead to serotonin syndrome which may include symptoms such as confusion, hallucination, seizure and increase in heart rate and blood pressure. In severe cases, death can be the outcome. The other medications do not have documented instances of drug/drug interactions with lithium. The correct answer is: Fluoxetine

A nurse is caring for a client prescribed the HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed? Select one: a. Visual acuity screenings b. Hearing screenings c. Renal function tests d. Liver function tests

Liver function tests Statins (HMG CoA reductase inhibitors) like atorvastatin can cause hepatotoxicity. Prior to initiating therapy the client's baseline liver function should be determined then liver function tests should be checked after 12 weeks of therapy and then every 6 months. The nurse should advise the client to observe for symptoms of liver dysfunction (anorexia, vomiting, nausea, jaundice) and to notify the provider if these occur.

A nurse is caring for a client prescribed hydromorphone for severe pain. The client's respiratory rate has decreased from 16 breaths per minute to 6. Which if the following medications should the nurse prepare to administer? Select one: a. Aluminum hydroxide b. Activated charcoal c. Naloxone d. Flumazenil

Naloxone This client is experiencing respiratory depression likely related to over administration of hydromorphone (Dilaudid). Naloxone (Narcan) and nalmefene (Revex) are opioid antagonists used to reverse an overdose of opioids.

Drug Class for glipizide

Oral hypoglycemic

A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism? Select one: a. Scleroderma b. Osteoporosis c. Asthma d. Peripheral Vascular Disease

Osteoporosis Caution should be used to prevent overtreatment with levothyroxine and monitor drug levels. Chronic overtreatment can cause atrial fibrillation and an increased risk of fractures from bone loss, especially in older adults.

A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? a. hemoglobin (Hgb) b. Prothrombin time (PT) c. Bleeding time d. Activated partial thromboplastin time (aPTT)

Prothrombin time The test is used to monitor warfarin therapy. For a client receiving full anticoagulant therapy, the PT should typically be approximately two to three times the normal value, depending on the indication for therapeutic anticoagulation.

classifications of diuretics to their mechanism of action Osmotic diuretics

Reduce intracranial pressure and intraocular pressure by raising serum osmolality and drawing fluid back into the vascular and extravascular space

A nurse has just administered a wrong medication to a client. Which of the following actions should the nurse take next? Select one: a. No action is needed. b. Inform the client that the wrong medication was given. c. Report error to the provider. d. Complete an institutional incident report.

Report error to the provider. The nurse should acknowledge the error and report it to the provider for further orders. The nurse should also monitor the client for adverse effects. The nurse should also complete an incident report per institutional policy after notifying the health care provider.

Which of the following agents is used for motion sickness? Select one: a. Scopolamine b. Misoprostol c. Raberprazole d. Oprelvekin

Scopolamine is an anticholingeric that interferes with the transmission of nerve impulses traveling from the vestibular apparatus of the inner ear to the vomiting center of the brain. Misoprostol prevents gastic ulcers from forming by promoting submucosal blood flow. Raberprazole is a proton pump inhibitor that reduces gastric acid secretion to prevent erosion and ulcers of the gut. Oprelvekin is a thrombopoietic growth factor agent to increase platelet production.

A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication? Select one: a. Take the medication on an empty stomach to maximize absorption. b. Decrease dietary fiber intake while taking this medication. c. Take prescribed antacids at the same time as this medication. d. Notify your provider if your stool becomes dark green.

Take the medication on an empty stomach to maximize absorption. The nurse should instruct the clients to take iron on an empty stomach, such as 1 hr before meals to maximize absorption. Stomach acid increases absorption. If GI adverse effects occur, the client can take with food to increase adherence to therapy even though absorption is also decreased.

The nurse knows that a client with renal insufficiency should be reevaluated for best diabetic management, when it is noted the client is on metformin. What is the reason metformin is contraindicated for clients who have renal insufficiency? Select one: a. The medication increases potassium excretion. b. The medication decrease renal perfusion. c. The medication increases glucose productions. d. The medication increases the risk of lactic acidosis.

The medication increases lactic acidosis. The medication does not decrease renal perfusion, increase potassium excretion or increase glucose production. The correct answer is: The medication increases the risk of lactic acidosis.

A nurse is preparing to administer a measles, mumps, and rubella vaccine (MMR) to an adult client. Which of the following is a contraindication to this vaccine? Select one: a. Client allergy to strawberries b. Client history of genital herpes c. The possibility of pregnancy within 4 weeks d. The possibility of overseas travel in the next month

The possibility of pregnancy within 4 weeks

Which of the following are contraindications to aspirin therapy? Select all that apply. Select one or more: a. Deep vein thrombus b. Adolescents with chickenpox c. Third trimester pregnancy d. Coronary artery disease e. Thrombocytopenia

Third-trimester pregnancy, Thrombocytopenia, Adolescents with chickenpox

A client has been prescribed isosorbide mononitrate. Which of the following should the nurse include in this client's education related to this medication? Select one: a. Take the medication in the evening after dinner. b. This medication is prescribed for long-term prophylaxis against anginal attacks. c. You can crush this medication if needed. d. Take an additional tablet if you experience chest pain.

This medication is prescribed for long-term prophylaxis against anginal attacks.

A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacological action of this medication? Select one: a. To increase blood pressure. b. To increase reabsorption of water in the renal tubules. c. To stimulate the pancreas to secrete insulin. d. To slow the absorption of glucose in the intestine.

To increase reabsorption of water in the renal tubules.

A client diagnosed with Parkinson's disease is prescribed levodopa. The nurse should instruct the client not to take over the counter pyridoxine supplements while taking this medication. Select one: True False

True Pyridoxine (vitamin B6) decreases the effects of levodopa. Clients should not take over the counter supplements without consulting their provider.

Antidote Vitamin K

Warfarin (Coumadin)

Before administering blood products, which action should be taken? Select one: a. Document client response. b. Prime IV tubing with 0.45% sodium chloride. c. Administer epinephrine. d. Assess the client's temperature.

When administering blood products, assess the client's vital signs, obtain consent for the procedure and ensure compatibility. Prime the IV tubing with 0.9% sodium chloride. The nurse would not document client response or administer epinephrine prior to starting the transfusion. The correct answer is: Assess the client's temperature.

classifications of diuretics to their mechanism of action Thiazide diuretics

Work in the early distal convoluted tubule to block the reabsorption of sodium and chloride and prevent the reabsorption of water that this site

classifications of diuretics to their mechanism of action Loop diuretics

Work on the ascending limb of the loop of Henle to block reabsorption of sodium and chloride and to prevent reabsorption of water.

A nurse is reviewing the medication class, benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the below clients? Select one: a. A client with glaucoma. b. A client with renal failure. c. A client with insomnia. d. A client with hypertension.

a. A client with glaucoma. Benzodiazepines can increase intraocular pressure due to the pupil-dilating effects of the medication.

before administering blood products, which action should be taken? a. Assess the client's temperature b. Document client response c. Prime IV tubing with 0.45% sodium chloride d. Administer epinephrine

a. Assess the client's temperature Assess the client's vital signs, obtain consent for the procedure and ensure compatibility. Prime the IV tubing with 0.9% sodium chloride. The nurse would not document client response or administer epinephrine prior to starting the transfusion.

A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication? Select one: a. Notify your provider if you experience restlessness or spasms of the face or neck. b. Decrease your fluid intake while taking this medication. c. This medication can cause urinary frequency. d. This medication can cause insomnia.

a. Notify your provider if you experience restlessness or spasms of the face or neck. An adverse effect of metoclopramide is extrapyramidal symptoms. The client should stop the medication and notify the provider if these occur.

A client has been prescribed lisinopril. Which of the following medication interactions should the nurse instruct this client about? Select one: a. Potassium supplements b. Escitalopram c. Ciprofloxacin d. Magnesium supplements

a. Potassium supplements Potassium supplements and potassium-sparing diuretics increase the risk of hyperkalemia in clients taking ACE inhibitors such as lisinopril. Clients should only take potassium supplements if prescribed by the provider. Clients should also avoid salt substitutes that contain potassium.

Which of the following are contraindications to salicylate acid therapy? (Select all that apply) a. Third trimester pregnancy b. Thrombocytopenia c. Coronary artery disease d. Adolescents with chickenpox e. Deep Vein Thrombus

a. Third Trimester Pregnancy b. Clients with bleeding disorders and thrombocytopenia d. Children and Adolescents with Chickenpox

Antidote Heparin

activated partial thromboplastin time (aPTT)

A nurse is caring for a client prescribed digoxin. Which the following should alert the nurse to possible digitalis toxicity? Select one: a. tachycardia and increased urination b. anorexia and weakness c. polyphagia and polydipsia d. hyperactivity and hunger

anorexia and weakness Anorexia, fatigue and weakness are signs of potential digitalis toxicity. GI effects of digitalis toxicity include anorexia, nausea, vomiting and abdominal pain. CNS effects include fatigue, weakness, vision changes (diplopia, blurred vision, yellow-green or white halos around objects). Bradycardia is also commonly noted in digitalis toxicity.

A nurse is caring for a client newly prescribed doxazosin mesylate. Which of the following instructions should the nurse include in client education regarding taking the first dose of this medication? Select one: a. There is no need to avoid normal activities. b. Change positions slowly and lie down if dizziness occurs. c. Do not eat green leafy vegetables. d. Avoid dairy products while taking this medication.

b. Change positions slowly and lie down if dizziness occurs. First-dose orthostatic hypotension can occur with doxazosin. The nurse should instruct clients to change positions slowly and to lie down if feeling dizzy, lightheaded or faint.

A nurse is preparing to administer bisacodyl suppository to a client. Which of the following actions should the nurse take? (Select all that apply) a. Don sterile gloves b. Lubricate index finger c. Use a rectal applicator for insertion d. Position client supine with knees bent. e. Insert suppository just beyond internal sphincter.

b. Lubricate index finger e. Insert suppository just beyond internal sphincter

A nurse is caring for a client receiving patient-controlled analgesia (PCA). Which of the following interventions should the nurse take while caring for this client? Select one: a. Advise the client to use the pump sparingly to prevent addiction. b. Encourage the client's family to administer PCA while client is sleeping. c. Encourage the client to use the PCA before dressing changes. d. Increase client's 4-hr limit as needed.

c. Encourage the client to use the PCA before dressing changes. The nurse should encourage the client to use the PCA prophylactically prior to activities that are likely to augment pain levels.

A 45-year-old client is taking methylprednisolone. What pharmacological action should the nurse expect with this therapy? Select one: a. Suppression of beta2 receptors. b. Fortification of bones. c. Suppression of airway mucus production. d. Suppression of candidiasis.

c. Suppression of airway mucus production. Corticosteroids, such as methylprednisolone will suppress airway mucus production.

A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription? Select one: a. Hypertension b. Urolithiasis c. Tachydysrhythmias d. Asthma

d. Asthma Clients with asthma should avoid Beta2 Blockade agents such as propranolol. Bronchoconstriction can occur. Clients with asthma should be administered a beta1 selective agent.

A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not seen with this therapy? Select one: a. Headache b. Orthostatic hypotension c. Tolerance d. Productive cough

d. Productive cough Nitroglycerin therapy does not directly have an effect lung function. Physiologically, vasodilation should effect capillary perfusion and decrease lung secretions.

A nurse is caring for a client receiving a dopamine infusion via a peripheral IV. Which of the following actions should the nurse take if the IV site appears infiltrated? Select one: a. Apply a warm compress to the site. b. Slow the infusion and continue to monitor the site. c. Apply a cold compress to the site. d. Stop the infusion.

d. Stop the infusion. If infiltration is suspected, the infusion should be stopped. Necrosis can occur from extravasation of high doses of dopamine. Extravasation can be treated with local injection of an alpha-adrenergic blocking agent, such as phentolamine.

expected pharmacological action. Erythropoietic growth factor that acts on the bone marrow to increase production of red blood cells.

epoetin alfa

expected pharmacological action. Leukopoietic growth factor that stimulates the bone marrow to increase production of neutrophils.

filgrastim

expected pharmacological action. Thrombopoietic growth factor that increase the production of platelets.

oprelvekin

Antidote Warfarin

prothrombin time (PT) and International Normalized Ratio (INR)

expected pharmacological action. Granulocyte macrophage colony stimulator that acts on the bone marrow to increase production of white blood cells (neutrophils, monocytes, macrophages, eosinophils).

sargramostim