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PHARMACOLOGY 2 Questions and
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NURSING>NURS 407>CAPSTONE
PHARMACOLOGY 2 Questions
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Answers>Aid for a Grade Boost.CAPSTONE PHARMACOLOGY 2
1. A nurse is caring for a client who reports using the herbal medication garlic along with
prescribed warfarin. The nurse should identify that which of the following is a potential adverse
effect of taking both of these products concurrently?
Altered renal perfusion
Elevated blood pressure
Increased ecchymosis- The nurse should identify that ecchymosis occurs when there is
bleeding under the skin. Additionally, the nurse should recognize that, garlic has
antiplatelets effects that can result in bleeding. When taken concurrently with an
anticoagulant, such as warfarin, there is an increased risk for bleeding.
2. A nurse is providing teaching t a client who is starting to take aspirin. The nurse should
instruct the client to monitor for which of the following findings as an adverse effect of this
medication?
Black, tarry stools- A client who takes aspirin can have an increased risk for bleeding
because aspirin suppresses platelet aggregation. The nurse should instruct the client to
monitor for and report indications of bleeding, such as bruising, petechiae, and blood in
stools or urine.
Nystagmus
Dry mouth
3. A nurse is caring for a client who has an infection and is starting to take gentamicin. Which of
the following client laboratory tests should the nurse monitor to detect an adverse effect of the
medication?
B-type natriuretic peptide (BNP)
Creatinine - The nurse should monitor creatinine, BUN and urine output for a client who
is receiving gentamicin, and aminoglycoside antibiotic. Gentamicin is an aminoglycoside
that has both nephrotoxic and ototoxic adverse effects.
Amylase level
4. A nurse is assessing a client who has diabetes insipidus and is starting intranasal
desmopressin. Which of the following findings should indicate to the nurse that medication is
effective?
The client has clear mucus
The client’s 24 hr urine output is 1.256 mL - Desmopressin is effective for the treatment
of diabetes insipidus, a disorder of the posterior pituitary gland in which large amount
of dilute urine are produced due to a deficiency in vasopressin. The action of
desmopressin causes reabsorption of water and a decrease in urine volume. A urine
output of 1.256 mL over 24 hr is within the expected reference range and indicates the
medication is effective.
5. A nurse is assessing a client who has a prescription for haloperidol 0.5 mg PO three times
daily. The medication administration record shows that the client received 5 mg per dose on the
previous day. Which of the following manifestations is the nurse’s priority to assess?
Muscle stiffness - The nurse should recognize tha the greatest risk to the client is
developing neuroleptic malignant syndrome, and adverse reaction to haloperidol that is
potentially fatal if not treated promptly. Manifestations of neuroleptic malignant
1
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shared via CourseHero.comsyndrome include extreme muscle stiffness, sudden increase in temperature,
diaphoresis, dysrhythmias, and fluctuations in blood pressure.
Blurred vision
Constipation
6. A nurse is assessing a client who received ondansetron 1 hr. ago. Which of the following
findigns should the nurse identify as a therapeutic effect of the medication?
Decreased pain
Suppressed emesis – Ondansetron suppresses nausea and vomiting induced by
chemotherapy, anesthesia, radiation therapy, or morning sickness by blocking serotonin
receptors in the upper GI tract and in the CNS
Supresed cough
Decreased fever
7. A nurse is caring for a client who is receiving morphine. Which of the following assessments
should the nurse perform first?
Apical heart rate
Blood pressure
Respiratory rate – When using the airway, breathing, circulation approach to client care,
the nurse should determine that the priority assessment is respiratory rate. The nurse
should withhold the morphine and notify the provider if the respiratory rate is less than
12/min.
8. A nurse is caring for a client who is at risk for alcohol withdrawal delirium. Which of the
following medications should the nurse expect the provider to prescribe?
Naloxone
Bupropion
Methadone
Chlordiazepoxide – The nurse should expect the provider to prescribe chlordiazepoxide,
a benzodiazepine, to a client who is at risk for alcohol withdrawal delirium.
Chlordiazepoxide can prevent the client form experiencing seizures as a result of
withdrawal and lessen the effects of withdrawal.
9. A nurse is teaching a client who is to start taking methyldopa for the treatment of
hypertension. Which of the following information should the nurse include in the teaching?
The medication can cause dizziness- Methyldopa can cause orthostatic hypotension and
dizziness when the client is changing position. Therefore, the nurse should instruct the
client to change position slowly while taking methyldopa.
This medication can cause insomnia
Expect to experience depression while taking this medication
10. A nurse is providing discharge instructions to a client who has a new prescription for
omeprazole for the treatment of GERD. Which of the following statements by the client indicates
an understanding of the teaching?
This medication kiss the bacteria in my stomach.
This medication neutralizes stomach acid
This medication coats the lining of my stomach.
This medication reduces stomach acid – GERD is a condition in which gastric acids
reflux from the stomach to the esophagus. Omeprazole is a proton inhibitor that
suppresses the production of gastric acid. The medication reduces baseline acid levels
2
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shared via CourseHero.comand blocks production of nearly all stimulated acid production within 2 hrs. of an oral
dose.
11. A nurse is caring for a client who requires a transfusion of one unit of packed RBCs. The
nurse receives the following prescription: Diphenhydramine 50 mg by mouth once, one hour
prior to transfusion. The nurse should identify this as which of the following types of
prescription?
PRN prescription
Standing prescription
Stat prescription
Single prescription
12. A nurse is providing teaching to a client who has prostate cancer and a new prescription for
leuprolide. The nurse should explain to the client that leuprolide treats prostate cancer by
which of the following actions?
Leuprolide decreases the production of testosterone -- Leuprolide treats prostate cancer
by decreasing the production of testosterone. It causes an initial increase in
testosterone, which results in desensitization and a subsequent decrease in testosterone
production.
Leuprolide kills cells at all stages of cellular division
Leuprolide increases estrogen levels in your body to counteract the cancer cells.
13. A nurse is reviewing the medical record of a client who has asthma and takes albuterol.
Which of the following findings should the nurse identify as an adverse effect of albuterol?
Fasting blood glucose 68 mg/dL
Heart rate 110/min – Above the expected reference rage of 60 to 100/min. Albuterol
can cause tachycardia because it increases the excitability of the beta 1 receptors in the
heart. More serious cardiac effects include palpitations, chest pain, hypertension, and
arrhythmia. The nurse should report these findings to the provider.
14. A nurse is caring for a client who has a systemic fungal infection and is receiving IV
amphotericin B deoxycholate. During previous infusions, the client developed a fever and chills.
Which of the following actions should the nurse take?
Apply a warming blanket prior to administration
Infuse the medication over 1 hr.
Administer diphenhydramine prior to administration—Infusion reactions often occur
following the administration of amphotericin B. The nurse should administer an
antipyretic, corticosteroid, antihistamine, or antiemetic prior to administration of
amphotericin B to minimize these effects
Monitor vital signs once per hour following administration.
15. A nurse is assessing a client who is in preterm labor and is receiving magnesium sulfate via
continuous IV infusion. Which of the followings should the nurse identify as the priority?
Flushing
Deep tendon reflexes 1+ -- When using the urgent vs. nonurgent approach to client care,
the nurse should determine that the priority finding is deep tendon reflexes 1+ , which
indicates a depressed CNS and possible magnesium sulfate toxicity.
Respiratory rate 22/min
3
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shared via CourseHero.com16. A nurse is preparing to administer medications to a client who has type 1 diabetes mellitus.
The client takes lispro insulin and has a new prescription for pramlintide. Which of the
following actions should the nurse take?
Monitor the client for weight gain
Monitor for hypoglycemia for 3 hrs. after pramlintide administration – The nurse should
monitor the client for manifestations of hypoglycemia for 3 hrs. after administering
pramlintide. Pramlintide does not cause hypoglycemia. However, when combined with
insulin, hypoglycemia can occur within 3 hors. Of administration. The client should take
pramlintide before meals along with lispro insulin.
Inject the pramlintide in the client’s upper arm
Administer pramlintide 30 min prior to a meal.
17. A nurse is caring for an older adult client who is confirmed positive for HIV and will begin
medication therapy. Which of the following instructions should the nurse give the client?
You will be prescribed more than one medication to fight the virus.
Your medication dose will need to be slightly stronger than the recommended range.
Your medication plan can also include an antibiotic medication.
You will need to take medication for the rest of your life
You can take St. John’s wort to minimize medication adverse effects
18. A nurse is caring for a client who has a new diagnosis of adrenal insufficiency. Which of the
following prescriptions should the nurse anticipate form the provider?
Phenytoin - anticonvulsant
Calcitonin – hormone med for Paget’s disease
Buspirone – Anxiolytic med to treat anxiety
Fludrocortisone – Fludrocortisone is a mineralcorticoid replacement medication used
for the treatment of adrenal insufficiency. The nurse should monitor the client for
hypertension and edema.
19. A nurse is providing teaching to a client who has erectile dysfunction and ahs a new
prescription for tadalafil. Which of the following client statements indicates an understanding
of the teaching?
I should crush this medication if I have difficulty swallowing
This medication can decrease my blood pressure—the client should understand that
tadalafil can cause hypotension. The nurse should instruct the client to take this
medication with nitrates because this can cause a sudden drop in blood pressure.
I can take this medication up to twice a day.
20. A nurse is assessing a group of clients. Which of the following findings is the priority to
report to the provider?
A client who is receiving IM betamethasone and has a casual blood glucose of 198/dL
A client whose heart rate changes from 110/mine to 75/min after receiving IV
amiodarone
A client who is receiving subcutaneous enoxaparin and report slight bruising at the
injection site
A client who is receiving continuous IV lidocaine and has a respiratory rate of 10/min –
Lidocaine is used to treat ventricular dysrhythmias. A decreased respiratory rate is a
4
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rate is unstable and this finding is the highest priority to report to the provider.
21. A nurse is reviewing the medical history of a client who has myasthenia gravis and is asking
about starting neostigmine. The nurse should identify which of the following client conditions
as a potential contraindication for cholinesterase inhibitor therapy?
Cataracts
Hypertension
Hypothyroidism
Peptic ulcer disease—Neostigmine, a cholinesterase inhibitor, increases gastric
secretions which would further exacerbate the peptic ulcer disease, thereby increasing
the risk for erosion and perforation.
22. A nurse is providing teaching to a client who has angina and a new prescription for
sublingual nitroglycerin tablet. Which of the following instructions should the nurse include in
the teaching?
Repeat up to four doses until pain is relieved.
Store unused tablets at room temperature – The client should not expose tablets to
moisture, heat, or air, and should replace the tablets 6 months after they are opened to
retain potency.
23. A nurse is providing teaching to a client who has a duodenal ulcer and is starting to take
sucralfate. Which of the following instructions should the nurse include in the teaching?
Take this medication with meals
Reduce dietary fiber while taking the medication
Administer an antacid with the medication
Increase fluid intake while taking the medication—The nurse should instruct the client
to increase their fluid and dietary fiber intake to prevent constipation, a potential
adverse effect of sucralfate.
24. A nurse is assessing a client who started taking furosemide 2 days ago and ahs a potassium
level of 3.1 mEq/L. Which of the following findings should the nurse expect?
Muscle rigidity of the extremities
Bounding radial pulses
Depressed deep tendon reflexes—A potassium level of 3.1 mEq/L is lower thatn the
expected reference range of 3.5 to 5 mEq/L and is an indication of hypokalemia. The
nurse should expect depressed deep tendon reflexes in a client who has hypokalemia
Increased bowel motility
25. A nurse is administering bumetanide to a client who has ascites. The nurse should
recognize that which of the following findings is an expected therapeutic effect of this
medication?
Decreased excretion of urine sodium
Increased urinary output-- The primary action of bumetanide , a loop diuretic, is to
increase the excretion of water and electrolytes through the urine. Bumetanide
decreases edema associated with heart failure, liver disease, or renal compromise by
increasing urinary output.
Decreased serum glucose
5
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shared via CourseHero.com28. A nurse is teaching a client who has a new prescription for benzonatate. Which of the
following statements by the client indicates an understanding of the teaching?
I should not drive while taking this medication --- adverse effects of benzonatate can
include sedation and dizziness.
This medication will help me cough up the mucus in my chest
I should decrease my dietary fiber intake while taking this medication
29. A nurse is teaching a client who has a new prescription for isoniazid to treat tuberculosis.
Which of the following information should the nurse include in the teaching?
You will have frequent sputum tests to monitor the effectiveness of this medication –
sputum specimen every 2 to 4 weeks to monitor the effectiveness of this medication.
The client is no longer infectious following three consecutives negative sputum cultures.
However, the client should continue the antibiotic treatment for 6 to 112 months.
You will be able to stop taking this medication after 1 month
You can take an antacid containing aluminum at the same time as this medication
30. A nurse is reviewing the health history of a client who experience migraine headaches and
has asked about a prescription for sumatriptan. Which of the following condition should the
nurse identify as a contraindication for taking sumatriptan?
Asthma
Kidney disease
Rheumatoid arthritis
Coronary artery disease – Client who has history or risk of coronary artery disease
should not take sumatriptan. The mediation can cause coronary vasospasm, ECG
changes, and hypertension.
31. A nurse is caring for a client who has chemotherapy- induced anemia. Thea nurse should
expect to administer which of the following medications to treat the anemia?
Sargramostim
Filgrastim
Epoetin – This medication stimulates red blood cell production and can reduce the need
for periodic blood transfusions.
Romiplostim
32. A nurse is teaching a client who has a seizure disorder and has a new prescription for
phenytoin. Which of the following client statements indicates an understanding of the teaching?
I will expect to have dark urine while taking this medication
I will take an extra dose of the medication if I have a breakthrough seizure
I will have my blood checked to monitor the medication levels – The client should have
serum phenytoin level tested to maintain therapeutic blood levels and prevent toxicity.
Therapeutic phenytoin levels range from 10 to 20 mcg/mL. Once a safe and therapeutic
dosage level is established, the client should continue to adhere to prescribed dosage
schedule and continue routine monitoring.
33. A nurse is monitoring a client who is receiving a continuous IV infusion of dopamine. Which
of the following findings requires immediate intervention by the nurse?
Hear rate 105/min
Increased blood pressure
6
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shared via CourseHero.com Infiltration of the peripheral IV – The greatest risk to this client is injury form infiltration
and extravasation of the dopamine solution, which can cause tissue necrosis. Therefore,
discontinue the infusion. After stopping the infusion, the nurse should treat the
infiltration with phentolamine to prevent further tissue damage.
34. A nurse is caring for a client who has hypertension and nephropathy due to type 2 diabetes
mellitus. The nurse should expect to administer which of the following medications to slow the
progression of the nephropathy?
Sitagliptin- control glucose levels and decrease hemoglobin A1C levels
Glipizide - control glucose levels and decrease hemoglobin A1 C levels
Metoprolol- hypertension to decrease blood pressure and reduce heart rate
Losartan – An angiotensin II receptor blocker, for hypertension and type 2 diabetes
mellitus to slow the progression of nephropathy.
35. A nurse is caring for a client who is having difficulty voiding following surgery. The nurse
notes palpable bladder distention. Which of the following medications should the nurse
anticipate administering to the client?
Furosemide
Lorazepam
Bethanechol – stimulates the muscarinic receptors of the genitourinary tract, which
causes relaxation of the trigone and sphincter muscles and contraction of the detrusor
muscle.
Atropine
36. A nurse is caring for a client who received excessive IV fluids in error. Which of the
following actions should the nurse take?
Contact the provider
Report the error to the charge nurse
Place an incident report in the client’s chart
Auscultate the client’s lungs
Check the client for peripheral edema
38. A nurse is assessing a client who has been taking hydrochlorothiazide. Which of the
following client statements indicates that the medication is effective?
The swelling in my feet has decreased.—diuretic , reduces edema and blood pressure by
increasing urine output.
My appetite has increased
I no longer feel depressed
39. A nurse is providing teaching to a client who has osteoporosis and is starting to take oral
ibandronate. Which of the following instructions should the nurse include in the teaching?
Take the medication immediately after a meal
Drink 8 ounces of mild when taking the medication
Take the medication before bedtime
Take one table of the mediation on the same date each month. --- The nurse should
instruct the client to take ibandronate on the same date each month to maintain
therapeutic medication levels.
40. A nurse is providing teaching to the parents of a child who is starting to take liquid ferrous
sulfate. Which of the following information should the nurse include in the teaching?
7
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intake to reduce it.
Milk increases the absorption of the medication
Administer the medication undiluted
41. A nurse is reviewing the mediation administration record (MAR) of a client who requires
fluticasone MDI one puff and albuterol MDI two puffs. Which of the following actions should the
nurse plan to take?
1. Have the client take one puff of fluticasone
2. Have the client rest for 5 mins.
3. Have the client take one puff of albuterol
4. Have the client rest for 1 min.
5. Have the client take the second puff of albuterol
44. A nurse erroneously administered a prescribed medication IV instead of IM to a client.
Which of the following actions is the nurse’s priority?
Assess the client – According to the nursing process, the first action is assess the client
for injury due to the medication error.
Report the error
Document the error
46. A nurse is transcribing a telephone prescription for acetaminophen 650 mg. by mouth daily
at bedtime. The nurse should identify that which of the following abbreviations are acceptable
to use when transcribing the prescription?
Abbreviate “by mouth” as “PO”
Abbreviate “daily” as “QD”
Abbreviate “acetaminophen” as “APAP”
47. A nurse is reviewing laboratory data for a client who is taking niacin to correct plasma lipid
levels. Which of the following findings should the nurse identify as an adverse effect of the
therapy?
Elevated alanine aminotransferase (ALT)—An adverse effect of niacin is hepatotoxicity,
indicated by an elevated ALT, aspartate aminotransferase, or lactic dehydrogenase level.
Clients who take niacin should have regular screenings of liver function to monitor for
hepatotoxicity.
Elevated troponin T
Elevated WBC count
48. A nurse is completing an admission assessment for a client who has been taking St. John’s
wort. The nurse should identify that which of the following medications can interact with St.
John’s wort?
8
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Furosemide
Citalopram – St. John’s wort interacts with many mediations and can cause serotonin
syndrome when combined with cocaine, amphetamines, and antidepressants, such as
citalopram. St. John’s wort decreases effectiveness of birth control pills, warfarin,
cyclosporine, digoxin, calcium channel blockers, steroids, HIV protease inhibitors, and
some chemotherapy agents.
Allopurinol
49. A nurse is reviewing a medical record of a client who takes lithium. Which of the following
findings is the priority to report to the provider?
WBC count 12,00/mm3
Sodium 130 mEq/L -- Lithium toxicity. A sodium level of 130 mEq/L is below the
expected reference range of 136 to 145 mEq/L and increases the risk of lithium toxicity.
Therefore, this finding is the priority to report to the provider. The nurse should monitor
for manifestations of lithium toxicity, such as vomiting, slurred speech, and muscle
weakness.
50. A nurse is providing teaching to a client who has fibromyalgia and a new prescription for
pregabalin. Which of the following instructions should the nurse include in the teaching?
Stop taking pregabalin immediately if you develop headaches
You should notify your provider if you experience facial swelling. --- A hypersensitivity
reaction, such as angioedema, can be life-threatening. Therefore, report manifestations
such as swelling of the face, tongue, or throat to the provider.
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