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PHARMACOLGY MIDTERM REVIEW 2023-2024 DETAILED QUESTIONS WITH ANSWERS AND RATIONALES

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PHARMACOLGY MIDTERM REVIEW 2023-2024 DETAILED QUESTIONS WITH ANSWERS AND RATIONALES 1. A nurse is caring for a 4-year-old child who is resistant to taking ... medication. Which of the following strategies should the nurse use to elicit the child’s cooperation? a. Offer the child a choice of taking the medication with juice or water b. Tell the child it is candy c. Hide the medications in a large dish of ice cream d. Tell the child he will have a shot instead 2. A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide? a. "Crushing the medication might cause you to have a stomachache or indigestion. i. Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing destroys protection. b. "Crushing the medication is a good idea, and I can mix it in some ice cream for you.” c. "Crushing the medication would release all the medication at once, rather than over time." d. "Crushing is unsafe, as it destroys the ingredients in the medication." 3. A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? a. A. Check the client's vital signs. i. Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. Assess for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm. b. Request a dietitian consult. c. Suggest that the client rests before eating the meal. d. Request an order for an antiemetic. 4. A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? a. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." b. "A pharmacist is the person to answer that question." c. "Heparin does not dissolve clots. It stops new clots from forming." i. Rationale: This statement accurately answers the client's question. d. "The oral medication you will take after this IV will dissolve the clot. 5. A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed? a. Thyroid hormone assay i. Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction. b. Liver function tests: i. Rationale: LFTs must be monitored before and during valproic acid therapy c. Erythrocyte sedimentation rate i. Rationale: This is not a necessary test related to lithium therapy. d. Brain natriuretic peptide 6. A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching? a. “If my breathing begins to feel tight, I will use the cromolyn immediately.” b. “I will be sure to take the albuterol before taking the cromolyn.” i. Rationale: The client should always use the bronchodilator (albuterol) prior to using the leukotriene modifier (cromolyn). Using the bronchodilator first allows the airways to be opened, ensuring that the maximum dose of medication will get to the client's lungs. c. “I will use both medications immediately after exercising.” d. “I will administer the medications 10 minutes apart.” 7. A nurse is completing a medication history for a client who reports using over-the- counter calcium carbonate antacid. Which of the following recommendations should the nurse make about taking this medication? a. Decrease bulk in the diet to counteract the adverse effect of diarrhea. b. Take the medication with dairy products to increase absorption. c. Reduce sodium intake. d. Drink a glass of water after taking the medication. i. Calcium carbonate is a dietary supplement used when the amount of calcium taken in the diet is not enough. Calcium carbonate may also be used as an antacid to relieve heartburn, acid indigestion, and stomach upset. The client should drink a full glass of water after taking an antacid to enhance its effectiveness. 8. A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? a. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." i. Rationale: However, these medications work in different ways to achieve therapeutic coagulation and must be given together until therapeutic levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to 5 days. When the client's PT and INR are within therapeutic range, the heparin can be discontinued. b. "I will call the provider to get a prescription for discontinuing the IV heparin today.” c. "Both heparin and warfarin work together to dissolve the clots." d. "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay." 9. A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? a. Check the pulse after medication administration. b. Take the medication with meals. c. C. Rinse the mouth after administration.

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PHARMACOLGY MIDTERM REVIEW 2023-2024 DETAILED QUESTIONS WITH ANSWERS AND RATIONALES

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