RN PassPoint- Pharmacology and Medication Management
A client with suspected myasthenia gravis is to undergo a test with edrophonium. The client asks if edrophonium can be used to treat myasthenia gravis. What is the nurse's best response?
The short half-life of edrophonium makes it impractical for long-term use.
An 18-month-old is diagnosed with otitis media and the parent asks what can ease the client's pain. Which medication would the nurse anticipate for pain relief?
children's liquid acetaminophen 5/ml q4h
A client's medication orders reads: Administer amoxicillin trihydrate 20 mg/kg PO divided q8h. The client weighs 75 lb (34 kg). How many milligrams of amoxicillin should the nurse administer for each dose? Record the answer as a whole number.
227
A client with deep vein thrombosis (DVT) has an IV infusion of heparin sodium infusing at 1,500 units/hr. The concentration in the bag is 25,000 units/500 ml. How many milliliters should the nurse document as intake from this infusion following an 8-hr shift? Record your answer using a whole number.
240
A child is receiving I.V. gamma globulin for treatment of Kawasaki disease. The order is for 8 g over 12 hours. The concentration is 8 g in 300 ml of normal saline. How many milliliters per hour will this child receive? Record your answer using a whole number.
25
A client with pneumonia is ordered azithromycin 500 mg I.V. daily via a peripheral I.V. catheter. The medication is pre-mixed from the pharmacy in a 50 ml bag of solution to be infused over 30 minutes. The I.V. tubing delivers 15 gtt/ml. At what drip rate should the nurse set the infusion pump? Record your answer using a whole number.
25
A 2-year-old child has tested positive for tuberculosis (TB), and has been started on rifampin. The child's parents ask the nurse if there is any important information they should know about this medication. What important adverse effect should the nurse inform these parents about?
orange body secretions
A child requires I.V. fluids to infuse at 27 ml/hr. The tubing delivers 60 gtt/ml. How many gtt/min should the nurse count to ensure that the fluid is safely infusing?
27 gtt/min
A nurse is teaching a client about tricyclic antidepressants. The nurse determines that teaching has been effective when the client states
"Improvement in my mood will take up to 28 days."
A 22 lb (10 kg) child is diagnosed with Kawasaki disease and started on gamma globulin therapy. The provider orders an I.V. infusion of gamma globulin, 2 g/kg, to run over 12 hours. What is the correct dose? Record your answer using a whole number.
20
Hydrocodone with acetaminophen has been prescribed for a client with metastatic prostate cancer. What information is essential for the nurse to include in the teaching plan?
"Constipation may develop with constant use."
A client is taking fluphenazine. The nurse understands that teaching and discharge instructions are understood when the client states:
"I need to stay out of the sun."
A nurse is about to give a client with type 2 diabetes mellitus the prescribed insulin before breakfast on the first day postpartum. Which client statement indicates an understanding of insulin requirements immediately postpartum?
"I will need less insulin now than during my pregnancy."
A nurse is providing instruction to a client undergoing treatment for anxiety and insomnia. The practitioner has prescribed lorazepam 1 mg PO t.i.d.. The nurse determines that teaching has been effective when the client states
"I'll avoid coffee."
A client with atrial fibrillation is prescribed warfarin. How should the nurse explain the purpose of this medication to the client?
"Warfarin is prescribed to people with atrial fibrillation to reduce the risk of having a stroke."
The home health nurse is speaking to the wife of a client with neurocognitive disorder due to Alzheimer's disease. The client has been taking donepezil. The nurse is most concerned when the caregiver states
"Yesterday, I managed to weigh my husband, and he has lost 8 lb this month."
A 7-year-old boy with a fractured right femur has been admitted to the pediatric unit following a car accident. The provider orders morphine 0.02 mg/kg I.V. for severe pain control. The client weighs 52 lb (23.6 kg) and is experiencing pain of 9 out of 10 on the pain scale. What dosage of morphine should the nurse administer to this client? Record your answer using two decimal places.
0.47
The nurse receives a prescription for amoxicillin 80 mg/kg/day to be administered in two divided doses to an infant who weighs 19 lb 8 oz (9 kg). The medication is supplied as 250 mg/ml. How many milliliters should the nurse administer for one dose? Record your answer using one decimal place.
1.4
A nurse is teaching a parent how to administer amoxicillin to the 5-year-old son. The child cannot swallow pills. The child weighs 20.6 lb (9.36 kg). The order is for 80 mg/kg/day given in two doses every 12 hours. The medication comes prepared as 250 mg/5 ml. How many teaspoons should the nurse instruct the parent to give with each dose? Record your answer using one decimal place.
1.5
A client with new-onset seizures of unknown cause is started on phenytoin. The healthcare provider has ordered a loading dose of 15 mg/kg I.V. to be given at a rate of 40 mg/min. What is the loading dose in milligrams if the client weighs 176 lb (80 kg)? Record your answer using a whole number.
1200
A client is to receive 100 mg of cefazolin following an open reduction and internal fixation for repair of a fractured femur. The pharmacy has sent 100 mg of cefazolin in 50 ml of dextrose. The medication is to be administered over 30 minutes. Calculate the drip rate (gtt/min) using a set with a drop factor of 20 gtt/ml. Record your answer using a whole number.
33
A client is admitted to the hospital with lower gastrointestinal bleeding. The client's hemoglobin on admission to the emergency department is 7.3 g/dl. The healthcare provider prescribes two units of packed red blood cells (RBCs) to infuse over one hour each. Each unit of packed RBCs contains 250 ml. The blood administration set has a drip factor of 10 gtt/ml. What is the flow rate in drops per minute? Record your answer using a whole number.
42
A client is ordered to receive 1,000 ml of 0.45% normal saline with 20 mEq of potassium chloride (KCl) over 6 hours. The infusion set administers 15 gtt/ml. How many drops per minute should this client receive? Record your answer using a whole number.
42
A client is admitted with a diagnosis of diabetic ketoacidosis. An insulin drip is initiated with 50 units of insulin in 100 ml of normal saline solution. The I.V. is being infused via an infusion pump, and the pump is currently set at 10 ml/hr. How many units of insulin each hour is this client receiving? Record your answer using whole number.
5
A client has been receiving oxytocin to augment her labor. The nurse notes that contractions are lasting 100 seconds. Which immediate action should the nurse take?
Stop the oxytocin infusion.
The nurse is instructing a client who will be discharged on anticoagulant therapy. What is the most important instruction for this nurse to include?
Take the anticoagulant at the same time each day.
The nurse is caring for a frail, older adult client who is experiencing pain. At the client care meeting, the family asks if it is safe for the client to receive narcotics. The nurse is aware that the client is receiving hydromorphone hydrochloride for pain. What is the nurse's most appropriate response to this family?
The narcotic is safe because it does not accumulate in the body.
A client calls the clinic worried about experiencing new symptoms after taking antipsychotic medicine. The client reports persistent, uncontrollable restlessness of the limbs and head despite improvement in psychotic symptoms. What is the most appropriate intervention by the nurse?
Direct the client to see the provider for medication to address these side effects.
The nurse is planning to administer morphine 1 mg I.V. to a client who is reporting pain. The available vial is morphine 2 mg/1 ml. What is the most appropriate action by the nurse?
Draw 0.5 ml of medication into a syringe and ask another nurse to witness the waste of 0.5 ml of medication.
A nurse is caring for a 7-year-old client receiving cyclophosphamide. In addition to administering mesna, which action should the nurse take?
Encourage the child to void frequently.
A client who received massive packed red blood cell (PRBC) blood transfusions due to trauma has a potassium level of 7.1 mEq/L (7.1 mmol/L). Which medication should the nurse expect to administer?
I.V. insulin
What is the most important information for the nurse to include when teaching a client about metronidazole?
Mixing this drug with alcohol causes severe nausea and vomiting.
The nurse is caring for a client with type 2 diabetes mellitus. One hour after taking an oral diabetic medication, the client becomes nauseated and vomits. What is the initial action of the nurse?
Monitor blood glucose closely, and assess for signs of hypoglycemia.
A client has been prescribed neomycin and polymyxin B sulfates and hydrocortisone otic suspension, two drops in the right ear. What action is most important for the nurse take when instilling the medication?
Verify the proper client and route.
Which assessment should a nurse do prior to administering disulfiram to a client with a history of alcohol abuse?
Which assessment should a nurse do prior to administering disulfiram to a client with a history of alcohol abuse?
Which medication can the nurse administer through a nasogastric (NG) tube?
acetaminophen
Which nursing intervention would help to decrease the adverse effects of radiation therapy on the gastrointestinal tract?
encouraging fluids and a soft diet
A depressed client has been taking a selective serotonin reuptake inhibitor (SSRI) in the evening, and is upset because he cannot perform sexually due to erectile problems. What is the nurse's best response?
engage in sexual activity prior to taking the drug
A client with a history of schizophrenia presents to the emergency department accompanied by police officers after assaulting a neighbor. The client is agitated and combative and cannot be reoriented. What prescribed medication should the nurse prioritize administering to the client?
haloperidol
Which medication would the nurse anticipate as the provider's treatment of choice for scarlet fever?
penicillin
A client with a history of bronchial asthma is prescribed propranolol to control hypertension. Before administering propranolol, which initial action should the nurse take?
question the provider about the order
The effectiveness of selective serotonin reuptake inhibitor (SSRIs) therapy, in a client with post traumatic stress disorder (PTSD), can be verified when the client states
"I'm sleeping better now."
What adverse reaction might the nurse observe after administering enteric-coated erythromycin to a client?
nausea and vomiting
A client with schizophrenia has been prescribed risperidone. The client's symptoms include hallucinations, delusions, and withdrawal. The nurse should explain that this medication will help improve:
negative and positive symptoms.
A client with acute pulmonary edema has been taking an angiotensin-converting enzyme (ACE) inhibitor. The nurse explains that this medication has been ordered to
reduce blood pressure.
Five days after running out of medication, a client taking clonazepam tells the nurse, "I know I shouldn't have just stopped the drug like that, but I'm OK." What is the nurse's most appropriate response?
"You could go through withdrawal symptoms for up to two weeks."
Chlorothiazide is ordered for a 1-year-old client with neonatal bronchopulmonary dysplasia (chronic lung disease). The dosage ordered is 30 mg/kg/day. The client weighs 10 kg. How much is given per dose when administered 2 times per day? Record your answer using a whole number.
150
A two-year-old child is showing signs of shock. A 10 ml/kg bolus of normal saline solution is ordered. The child weighs 40 lb (18.18 kg). How many milliliters should be administered? Round your answer using a whole number.
182
A nurse is preparing a dose of amoxicillin for a 3-year-old with acute otitis media. The child weighs 33 lb (15 kg). The dosage prescribed is 50 mg/kg/day in divided doses every 8 hours. The concentration of the drug is 250 mg/5 ml. How many milliliters should the nurse administer? Record your answer using a whole number.
5
A toddler weighing 27.6 lb (12.5 kg) is to receive 4 ml/kg/hr of intravenous normal saline solution. The nurse will administer the fluid using microdrip tubing that delivers 60 gtt/ml. How many milliliters per hour should this client receive? Record your answer using a whole number.
50
After undergoing small-bowel resection, a client is prescribed metronidazole 500 mg I.V. The mixed I.V. solution contains 100 milliliters. A nurse is to run the drug over 30 minutes. The drip factor of the available I.V. tubing is 15 gtt/ml. What is the drip rate? Record your answer using a whole number.
50
The health care provider is preparing a plan of care for a client with borderline personality disorder. Which medication would the nurse anticipate for this client?
Selective serotonin reuptake inhibitors (SSRIs), along with an atypical antipsychotic, are used to treat mood instability and impulsivity.
The nurse is teaching the parents of a child with growth hormone deficiency how to administer growth hormone to their child. At what time should the nurse suggest administration of this medication?
at bedtime
A client is receiving spironolactone to treat hypertension. Which instruction should the nurse provide?
avoid salt substitutes
The nurse understands that certain medications protect the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation. Which class of medications serve this function?
beta-adrenergic blockers
The health care provider has prescribed salicylates for an older adult client with osteoarthritis to relieve pain. The nurse knows to assess the client for what potential adverse reaction?
hearing loss
A definitive diagnosis of pulmonary embolism has been made for a client. Which medication would the nurse anticipate for this client?
heparin
A nurse is reviewing the healthcare provider's orders for a client admitted with systemic lupus erythematosus (SLE). Which medication would the nurse expect to find in this client's plan of care?
hydroxychloroquine
A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale had been prescribed a loop diuretic to treat peripheral edema. The nurse should monitor the client closely for what side effect of loop diuretic therapy that could worsen the client's hypercapnia?
hypokalemia
The nurse is providing discharge instructions for a client who is receiving chemotherapeutic medications. Which intervention is most important to prevent hemorrhagic cystitis?
increasing fluid intake
A client is experiencing status asthmaticus. For which would the nurse anticipate an immediate order?
inhaled Beta-2 adrenergic agonist
The nurse is admitting a client diagnosed with diabetic ketoacidosis (DKA). What is the nurse's priority intervention?
intravenous insulin
A nurse is assessing a client with bipolar disorder. The client tells the nurse that the family health care provider prescribed lithium. Which symptom would indicate that the client is developing lithium toxicity?
lethargy
A laboring client in the latent stage of labor begins reporting pain in the epigastric area, blurred vision, and a headache. Which medication would the nurse anticipate for these symptoms?
magnesium sulfate
A client with type 1 diabetes mellitus often skips their ordered dose of insulin. What priority information should the nurse give to this client regarding the omission of insulin doses?
may lead to ketoacidosis
A nurse is caring for a school-age client who is in the second percentile of height and weight for age as a result of an endocrine disorder. Which pharmacological intervention should the nurse anticipate?
replacement with biosynthetic growth hormone
A client who is receiving acetaminophen for osteoarthritis reports continuing pain. The healthcare provider prescribes celecoxib. What important information regarding this medication, should the nurse share with this client?
report black and tarry stools to the health care provider
A client is prescribed morphine following a myocardial infarction. What effects of morphine should the nurse explain to the client? Select all that apply.
sedation pain relief diminished anxiety decreased myocardial oxygen demand
A nurse is teaching a client diagnosed with a pulmonary embolism about the prescribed heparin therapy. The nurse determines that teaching has been effective when the client states heparin is given to
slow the development of other clots.
A client diagnosed with major depressive disorder three weeks ago reports feeling better since taking the prescribed antidepressant medication. The nurse prioritizes what assessment?
suicidal ideation
What is the most important information for the nurse to include when teaching a 17-year-old female client about the adverse effects of isotretinoin?
teratogenicity
A nurse is teaching a client who has HIV about the adverse effects of saquinavir. What information is important to include?
thrombocytopenia
The nurse receives an order to administer morphine to a client with an acute myocardial infarction. What is the purpose of this medication?
to decrease myocardial oxygen demand
The family of a client in rehabilitation following heroin withdrawal asks a nurse why the client is receiving naltrexone. What is the nurse's best response?
to help reverse withdrawal symptoms
A 47-year-old client has been taking prescribed medication for an intestinal ulcer. During a routine office visit for blood pressure monitoring, the client reports he is no longer able to have sexual intercourse with his spouse. The nurse determines that this is most likely the result of:
ulcer medication
