Pharmacology exam practice

The client arrives at the emergency department complaining of back spasms. The client states, "I have been taking 2 to 3 aspirin every 4 hours for the last week, and it hasn't helped my back." Since acetylsalicylic acid intoxication is suspected, the nurse should assess the client for which manifestation? 1.Tinnitus 2.Diarrhea 3.Constipation 4.Photosensitivity

1

The nurse is teaching a client with hyperthyroidism about the prescribed medication, propylthiouracil. The nurse determines that teaching has been successful if the client states to report which symptom to the primary health care provider (PHCP)? 1.Fever 2.Fatigue 3.Excitability 4.Nervousness

1

Insulin glargine is prescribed for a client with diabetes mellitus. The nurse should tell the client that it is best to take the insulin at which time? 1.At bedtime every day 2.1 hour after each meal 3.15 minutes before the morning and evening meals 4.Before each meal, on the basis of the blood glucose level

1 Insulin glargine is a long-acting recombinant DNA human insulin used to treat type 1 and type 2 diabetes mellitus. It has 24-hour duration of action and is administered once a day at the same time each day.

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving theophylline. The nurse monitors the serum theophylline level and concludes that the medication dosage may need to be increased if which value is noted? 1.5 mg/mL (20 mcmol/L) 2.10 mg/mL (40 mcmol/L) 3.15 mg/mL (60 mcmol/L) 4.20 mg/mL (79 mcmol/L)

1 Thetherapeutic concentrationfortheophylline, when used as a bronchodilator to treat asthma, is generally considered to be 5-15 mcg/mL (28-83 micromol/L) for adults, 5-10 mcg/mL (28-55 micromol/L) for children and neonates.Levelsgreater than 20 mcg/mL (111 micromol/L) are consideredtoxic. So with value of 5 mg/mL (20 mcmol/L) indicated that the therapeutic serum range is very low. And thus need to increase dosage

The nurse is teaching the client about his prescribed prednisone. Which statement, if made by the client, indicates that further teaching is necessary? 1."I can take aspirin or my antihistamine if I need it." 2."I need to take the medication every day at the same time." 3."I need to avoid coffee, tea, cola, and chocolate in my diet." 4."If I gain 5 pounds or more a week, I will call my doctor."

1. "I can take aspirin or my antihistamine if I need it."

The home care nurse is reviewing the record of a client newly diagnosed with glaucoma who is scheduled for a home visit. The nurse notes that the primary health care provider (PHCP) has prescribed atropine sulfate and pilocarpine hydrochloride eye drops. The nurse should contact the PHCP before the home visit for which reason? 1.Clarify the prescription for the atropine sulfate. 2.Clarify the prescription for the pilocarpine hydrochloride. 3.Determine the date of the scheduled follow-up PHCP visit. 4.Determine the extent of the intraocular pressure caused by the glaucoma.

1. Clarify the prescription for the atropine sulfate.Rationale:Atropine sulfate is a mydriatic and cycloplegic medication that is contraindicated in clients with glaucoma. Mydriatic medications dilate the pupil and cause increased intraocular pressure in the eye. Pilocarpine hydrochloride is a miotic agent used in the treatment of glaucoma. It is unnecessary to contact the HCP regarding the date for follow-up treatment. In fact, the client may know this date, which the nurse can ask about during the home care visit. It is unnecessary to know the extent of the intraocular pressure caused by the glaucoma in planning care for the client.

A client is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? Select all that apply. 1.Hypoglycemia may be experienced before dinnertime. 2.The insulin dose should be decreased if illness occurs. 3.The insulin should be administered at room temperature. 4.The insulin vial needs to be shaken vigorously to break up the precipitates. 5.The NPH insulin should be drawn into the syringe first, then the regular insulin.

1. Hypoglycemia may be experienced before dinnertime. 3. The insulin should be administered at room temperature.

The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase, an antineoplastic agent. The nurse contacts the primary health care provider before administering the medication if which disorder is documented in the client's history? 1.Pancreatitis 2.Diabetes mellitus 3.Myocardial infarction 4.Chronic obstructive pulmonary disease

1. Pancreatitis Asparaginase is contraindicated if hypersensitivity exists, in pancreatitis, or if the client has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between dose administrations. The client needs to be monitored for signs of pancreatitis, which include nausea, vomiting, and abdominal painThe conditions noted in options 2, 3, and 4 are not contraindicated with this medication.

The nurse is reviewing the primary health care provider's (PHCP's) prescriptions for a client recently admitted to the hospital and notes that the PHCP has prescribed ticlopidine therapy. Which finding on the client's record would indicate a need to contact the PHCP before initiating the medication prescription? 1.Neutropenia 2.Client history of stroke 3.Client history of hypertension 4.Complaints of gastrointestinal disturbances

1.Neutropenia Rationale:Neutropenia, or agranulocytosis, is the most serious adverse effect associated with the use of ticlopidine. A baseline complete blood cell (CBC) count with differential will be performed for the client. Neutropenia occurs most often within the first 3 months of therapy; therefore, a CBC with differential is recommended every 2 weeks during the first 3 months. If a diagnosis of neutropenia is determined, the client will be withdrawn from therapy. This medication is used to prevent a stroke and is not contraindicated in hypertension. Gastrointestinal disturbances can occur as a result of taking the medication, and the client is instructed to take the medication with food to minimize these side effects.

The nurse is preparing an intravenous (IV) infusion of phenytoin as prescribed by the primary health care provider for the client with seizures. Which solution should the nurse plan to use to dilute this medication? 1.Dextrose 5% 2.Normal saline solution 3.Lactated Ringer's solution 4.Dextrose 5% and half-normal saline (0.45%)

2

The nurse is describing the medication side and adverse effects to a client who is taking oxazepam. Which information should the nurse incorporate in the discussion? 1.Consume a low-fiber diet. 2.Increase fluids and bulk in the diet. 3.Rest if the heart begins to beat rapidly. 4.Take antidiarrheal agents if diarrhea occurs.

2 Increase fluids and bulk in the diet Oxazepam causes constipation, and the client is instructed to increase fluid intake and bulk (high fiber) in the diet. If the heart begins to beat fast, the health care provider (HCP) is notified because this could indicate overdose. In addition, diarrhea could indicate an incomplete intestinal obstruction and, if this occurs, the HCP is notified.

The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine. Which information would be important for the nurse to obtain during this client visit regarding the side and adverse effects of the medication? 1. Cardiovascular symptoms 2. Gastrointestinal dysfunctions 3. Problems with mouth dryness 4. Problems with excessive sweating

2. Gastrointestinal dysfunctionsRationale:The most common adverse effects related to fluoxetine include central nervous system (CNS) and gastrointestinal (GI) system dysfunction. This medication affects the GI system by causing nausea and vomiting, cramping, and diarrhea. Options 1, 3, and 4 are not adverse effects of this medication.

The nurse is caring for a client who is receiving dopamine. Which potential problem is a priority concern for this client? 1.Fluid overload 2.Peripheral vasoconstriction 3.Inability to perform self-care 4.Inability to discriminate hot or cold sensations

2. Peripheral vasoconstriction

The nurse is caring for a client who was prescribed furosemide. The nurse should monitor the client for damage of which kidney structure? 1.Pelvis 2.Calyx 3.Nephron 4.Renal artery

3

A client with diabetes insipidus asks the nurse about the purpose of a new medication, vasopressin. The nurse provides teaching about the medication. Which statement by the client indicates successful teaching? 1."It causes muscle contractions." 2."It opens up my blood vessels." 3."It prevents me from 'peeing' so much." 4."It decreases stomach and colon motility."

3 Diabetes insipidus is an abnormal health condition that occurs due to lack of production of Antidiuretic hormone (ADH) or the inability of the kidney to respond to produced antidiuretic hormone. This can occur as a result of head trauma, tumours of pituitary gland or genetic origin. The common symptoms of Diabetes insipidus includes: --> Excessive production of dilute urine (polyuria) --> Increased thirst (polydipsia). In the management of diabetes insipidus, VASOPRESSIN medication is introduced. It has an antidiuretic effect. In its mechanism of action, it decreases water excretion by the kidney through increasing water reabsorption in the collecting ducts, Therefore the statement made by the patient indicates successful teaching as it helps reduce the volume of urine produced leading to decrease in frequent urination.

A client who has been receiving theophylline by the intravenous (IV) route has the medication prescription changed to an immediate-release oral form of the medication. After discontinuing the IV medication, when should the nurse schedule the first dose of the oral medication? 1.Just after the next meal 2.Just before the next meal 3.4 hours after discontinuing the IV form 4.Immediately on discontinuing the IV form

3 Rationale: 4 hours after discontinuing the IV formWith immediate-release preparations, oral theophylline should be administered 4 to 6 hours after discontinuing the IV form of the medication. If the sustained-release form is used, the first oral dose should be administered immediately on discontinuation of the IV infusion. Therefore the remaining options are incorrect.

A hospitalized client is started on a monoamine oxidase inhibitor (MAOI) for the treatment of depression. The nurse should instruct the client that which foods are acceptable to consume while taking this medication? Select all that apply. 1.Figs 2.Yogurt 3.Crackers 4.Aged cheese 5.Tossed salad 6.Oatmeal raisin cookies

3,5

The client with hyperparathyroidism is taking alendronate. Which statements by the client indicate understanding of the proper way to take this medication? Select all that apply. 1."I should take this medication with food." 2."I should take this medication at bedtime." 3."I should sit up for at least 30 minutes after taking this medication." 4."I should take this medication first thing in the morning on an empty stomach." 5."I can pick a time to take this medication that best fits my lifestyle as long as I take it at the same time each day."

3. "I should sit up for at least 30 minutes after taking this medication." 4. "I should take this medication first thing in the morning on an empty stomach."

Silver sulfadiazine is prescribed for a client with a partial-thickness burn, and the nurse provides teaching about the medication. Which statement made by the client indicates a need for further teaching about the treatments? 1. "The medication is an antibacterial."2. "The medication will help heal the burn."3. "The medication is likely to cause stinging every time it is applied."4. "The medication should be applied directly to the wound."

3. "The medication is likely to cause stinging every time it is applied." Rationale: silver sulfadiazine is an antibacterial that has a broad spectrum of activity against gram-negative bacteria gram positive bacteria, and yeast. It is applied directly to the wound to assistant healing. It does not cause stinging when applied.

The nurse in the postpartum unit notes that a new mother was given methylergonovine intramuscularly following delivery. What assessment finding indicates that the medication was effective? 1.Lochia that is serous 2.Normal blood pressure 3.Decreased uterine bleeding 4.Decreased uterine contractions

3. Decreased uterine bleeding(used to prevent or control postpartum hemorrhage by contracting the uterus)

A thrombolytic is administered in the hospital emergency department to a client who has had a myocardial infarction. The client's spouse asks the nurse about the purpose of the medication. The nurse bases the response on which fact regarding this medication? 1.Thrombolytics suppress the production of fibrin. 2.Thrombolytics act to prevent thrombus formation. 3.Thrombolytics act to dissolve thrombi that have already formed. 4.Thrombolytics have been proved to reverse all detrimental effects of heart attacks.

3. Thrombolytics act to dissolve thrombi that have already formed.Rationale:Thrombolytics are most effective when started within 4 to 6 hours after symptom onset and act to dissolve or lyse existing thrombi that are causing a blockage.

A client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? 1.Weight loss 2.Relief of heartburn 3.Reduction of steatorrhea 4.Absence of abdominal pain

3.Reduction of steatorrhea Rationale: Pancrelipase is a pancreatic enzyme used in clients with pancreatitis as a digestive aid. The medication should reduce the amount of fatty stools (steatorrhea). Another intended effect could be improved nutritional status. It is not used to treat abdominal pain or heartburn. Its use could result in weight gain but should not result in weight loss if it is aiding in digestion.

The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report which finding? 1.Impaired sense of hearing 2.Gastrointestinal side effects 3.Orange-red discoloration of body secretions 4.Difficulty in discriminating the color red from green

4

The nurse is caring for a client who is receiving asparaginase. The nurse should monitor the client for improvement of which condition? 1.Lung cancer 2.Breast cancer 3.Metastatic prostate cancer 4.Acute lymphocytic leukemia

4

Meperidine hydrochloride is prescribed for a client with pain. What should the nurse monitor for as a side or adverse effect of this medication? 1.Diarrhea 2.Bradycardia 3.Hypertension 4.Urinary retention

4.Urinary retention