Pharmacology Final Exam Review Questions (Open book quizzes & NCLEX Review Questions)
Quiz 6
1.) Potassium chloride 10 mEq intravenously has
... [Show More] been ordered for a client whose potassium is 2.9 following diuretics. How will the nurse administer the potassium dose?
2.) A client who has been taking Lisinopril (an ace inhibitor) for 2 weeks complains of a dry cough. How should the nurse respond to this complaint?
3.) A client is experiencing edema. Which over-the-counter medication might be reducing the diuretic effects of her lisinopril?
4.) A client, who has been seeing multiple doctors, reports that she is taking Lisinopril and another antihypertensive medication, the name of which she can’t recall. What type of antihypertensive is contraindicated when people are taking ACE inhibitors due to risk of compound effects?
5.) In preparing discharge education for a client who has just begun hydrochlorothiazide therapy, a nurse reviews the client's lab results. Which finding should the nurse be concerned about in relationship to the discharge prescription?
6.) A client has had hypertension for approximately 7 years and now is interested in becoming pregnant. What is the safest anti-hypertensive for a woman in the early stages of pregnancy?
7.) If a client is taking carvedilol, a beta blocker, which adverse effect should the nurse watch for?
8.) While preparing to administer a scheduled dose of digoxin, the nurse finds a new lab result showing a digoxin level of 0.7 ng/mL. What action should the nurse take?
9.) A client has been taking digoxin 0.25 mg, and furosemide 40 mg, daily. Upon routine assessment by the nurse, the client states, “I see yellow halos around the lights.” The nurse should perform which of the following actions based on this assessment?
10.) A client with angina is preparing to go home with a prescription for Nifedipine, a calcium channel blocker. What should the client be taught?
11.) A client with stable angina asks why the physician told her to put her nitro patch on at 8am and take it off at 8pm. What explanation should he be given?
12.) A client with stable angina as starting treatment with nifedipine a calcium channel blocker. The client’s spouse asks how nifedipine alleviates chest pain. How should the nurse respond?
13.) The nurse is providing patient education to a patient who has just been given a new prescription for sublingual nitroglycerin tablets. Which statement by the client would indicate a need for additional teaching?
14.) A client presents to the emergency department with chest pain. On a scale of 1:10 he rates the pain as a 6. His respiratory rate is 22. His blood pressure is 156/92. His heart rate is 110. He is afebrile. What other information should the nurse obtain before administering nitroglycerin?
15.) A client is being discharged to his home on enoxaparin (Lovenox) injections for treatment of deep vein thrombosis (DVT). Which of the following statements made by the client indicates a need for further discharge teaching by the nurse?
16.) A client is brought to the emergency department for accidental warfarin (Coumadin) overdose. The nurse determines that the client has no apparent signs of bleeding. Which action should the nurse take next?
17.) In which of the following situations should the nurse prepare to administer of protamine sulfate?
18.) A client is starting sildenafil (Viagra) for the treatment of pulmonary hypertension. Which of these medications could cause a serious reaction if they are taken with sildenafil?
Table for Individual Question Feedback
19.) Atenolol (Tenormin) has been prescribed for a client who is recovering from a recent heart attack. The nurse would consult the provider before giving the medicine in which of these situations? (Select all that apply.)
20.) A client presents in the clinic with concerns of having taken his dabigitran (Pradaxa) twice this morning. Realizing that this is a new oral anticoagulant (NOAC), what should the nurse do next? (Select all that apply.)
Quiz 7
1.) In preparing to administer albuterol (Proventil) and beclomethasone (Beconase) inhalers to an asthmatic client, what is most important for the nurse to remember?
2.) A hospitalized patient receives codeine as an antitussive. What type of client could be harmed by cough suppression?
3.) A patient with a pneumonia-related cough has been advised to add guaifenesin to the regimen of antibiotics. The client asks about the purpose of the drug. How should the nurse’s respond? guaifenesin will
4. ) The nurse is providing patient education to an elderly being treated for duodenal ulcers with Carafate (Sucralfate). The client asks the nurse how sucralfate helps heal ulcers. How should the nurse respond?
5.) The nurse is providing education to a client who has been prescribed both an antacid and ranitidine (Zantac). Which instruction should the nurse give the client about taking the medications?
6.) The nurse is preparing to give medications to a client taking sucralfate (Carafate) and ciprofloxacin (Cipro). The drugs are ordered for 0900. In what manner should the nurse proceed to administer the drugs
7.) The nurse who is caring for a post-operative client administers Compazine, a phenothiazine (related to Thorazine). What side effects should the nurse watch for, given this classification?
8.) For patients who don’t require PPIs or H2 inhibitors, antacids should be taken
9.) When teaching a client with renal insufficiency how to manage constipation, what teaching point should the nurse convey about laxatives?
10.) Which of these teaching points about gastro-esophageal reflux would be helpful to a client with reflux?
11.) The ventrogluteal site is recommended when intramuscular opiates are ordered to treat abdominal pain. What are the Landmarks for the ventrogluteal site?
12.) A mother brings her 17-year-old daughter to the emergency department and states that the daughter took 40 extended-release acetaminophen tablets. What medication should the nurse procure so it is available when the provider's orders that it should be given.
13.) A spouse is requesting that an alternative for lactulose be given to a constipated client with elevated liver enzymes. How should the nurse respond?
14.) Which antiepileptic medication is considered safer than others in pregnancy
15.) Which of these immune modifiers would the nurse question in pregnancy?
16.) A pregnant client is suffering from acid indigestion. The nurse would question giving which of these medicines for epigastric distress to a woman who was pregnant?
17.) An asthmatic client comes into the emergency room with rapid pulse, rapid respirations, minimal breath sounds in the bases. Which of these therapies should the nurse anticipate, and have available, pending providers order
18.) A client has been prescribed Librax (chlordiazepoxide and clidinium), an anticholinergic benzodiazepine, for irritable bowel syndrome. Which of these conditions would constitute a contraindication for Librax?
19.) A spouse of a hospice client wants to know why the sublingual dose of morphine is so much lower than the MS Contin dose that was given orally, and the IM injection dose that was given in the hospital. How should the nurse respond? (Select all that apply)
20.) A client who is taking Haldol, Aricept, Colace, TUMs and Ampicillin is having loose stools. Which of these may be contributing to the diarrhea?
1.) When metronidazole (Flagyl) is a component of the H. pylori treatment regimen, what instructions should the client receive?
2.) What advice should the nurse offer a client who is being started on a significant amount of Prednisone? Select all that apply.
3.) In which of these situations would the nurse question the administration of steroid eye drops?
4.) Lantus Insulin (glargine) is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug?
5.) A client in ketoacidosis needs intravenous insulin. What should the nurse understand before giving IV insulin?
6.) A client calls from home to report that his lispro (Humalog) insulin appears cloudy. What would be the nurse’s best response?
7.) A client with type I diabetes who takes insulin reports taking propranolol for hypertension. Why would this cause the nurse to be concerned?
8.) The nurse manages care for a client with diabetes who takes metformin (Glucophage). Which laboratory result would cause the nurse to question the prescription?
9.) The nurse is providing client education after laboratory findings reveal am elevated thyroid- stimulating hormone (TSH). How would the nurse best explain the implications of the laboratory finding to the client?
10.) A steroid dependent client has a blood glucose level of 249 mg/dL. Her blood pressure is 178/99 and she is complaining of muscle aches and weakness. Her face appears very round and puffy.” What would the nurse suspect? What type of advocacy does the client need?
11.) A client being followed for latent tuberculosis has been on isoniazid therapy for 2 months. The nurse notes that the liver function test results have become grossly abnormal during that interval. What should the nurse do?
12.) A client, who is taking rifampin, telephones the nurse to say, “My urine and saliva have looked orange-red for the past 2 days.” Select the nurse’s best response.
13.) A client with persistent pain due to cancer is brought to the emergency department by his spouse. Upon assessment, the nurse notes pinpoint pupils and a respiratory rate of 6 breaths per minute. The nurse should immediately prepare for administration of which medication?
14.) A client taking amitriptyline (Elavil) complains of having blurred vision and dry mouth, and he states that he hasn’t had a bowel movement in 3 days, whereas he normally has one daily. His vital signs are temperature 97.6° F, pulse 90/minute, blood pressure 130/79 mm Hg, and respirations 20/minute. Based on this assessment, the nurse should suspect which of the following causes?
15.) The nurse is preparing to administer lithium (Eskalith), to a client with bipolar disorder whose lithium level is 2.0 mEq/L. What symptoms might the nurse expect to see? (Select all that apply.)
16.) A client who has been taking an antiepileptic medication with a narrow therapeutic window for 2 weeks seems confused and forgetful. What should be the priority action of the nurse?
17.) A nurse in the emergency department is caring for a client whose family reports that she had taken an overdose of diazepam. Which of the following medications should the nurse have available to reverse the CNS depression caused by this drug?
18.) A nurse is reviewing a client’s list of medications and notices that he is taking two anticholinergics. Which of his recent symptoms could be caused by his anticholinergic medications? (Select all that apply)
19.) A client is using a prn scopolamine patch for motion sickness. Knowing that the medication has anticholinergic side effects, the client should be taught to anticipate which side effects? (Select all that apply!)
20.) A nurse recognizes that the actions of benzodiazepines include which of the following benefits? (Select all that apply.)
21.) A 68 year old male has a history of seizures and has been taking phenytoin (Dilantin) for years. His last seizure occurred 2 years ago, so he has decided that he no longer needs the medication. What would be the best action of the nurse? (Select all that apply.)
NCLEX Study Questions from textbook
Respiratory
1.) A patient tells the nurse that he has started to take an over-the-counter (OTC) antihistamine, diphenhydramine (Benadryl). In teaching about side effects, what is most important for the nurse to tell the patient?
2.) A patient complains of a sore throat and has been told it is due to beta-hemolytic streptococcal infection. The nurse anticipates that the patient has which acute condition?
3.) A patient is prescribed the decongestant oxymetazoline (Afrin) nasal spray. What will the nurse teach the patient?
4.) A patient has been prescribed guaifenesin (Robitussin). The nurse understands that the purpose of the drug is to accomplish what?
5.) Beclomethasone (Beconase) has been prescribed for a patient with allergic rhinitis. What should the nurse teach the patient regarding this medication?
6.) The nurse is teaching a patient about diphenhydramine (Benadryl). Which instructions should the nurse include in the patient's teaching plan? (Select all that apply.)
Respiratory
1.) An Advair Diskus, fluticasone propionate (Flonase) and salmeterol (Serevent) 100 mcg/50 mcg, is ordered for a patient with COPD. What does the nurse know about this medication? (Select all that apply.)
2.) A patient with COPD has an acute bronchospasm. The nurse anticipates that the health care provider will prescribe which medication?
3.) A patient is prescribed aminophylline–theophylline. For what adverse effect should the nurse monitor the patient?
4.) A patient is receiving IV aminophylline. The nurse checks the patient's lab values. The serum theophylline level is 32 mcg/mL. What action should the nurse take?
5.) A patient with COPD is taking a leukotriene antagonist, montelukast (Singulair). The nurse is aware that this medication is given for which purpose?
Cardiac
1.) The patient is receiving digoxin for treatment of heart failure. Which finding would suggest to the nurse that heart failure is improving?
2.) The patient's serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum digoxin level?
3.) The nurse is assessing a patient for possible evidence of digitalis toxicity. The nurse acknowledges that which is included in the signs and symptoms for digitalis toxicity?
4.) A patient is taking a potassium-depleting diuretic and digoxin. The nurse expects that a low potassium level (hypokalemia) could have what effect on digoxin (Lanoxin)?
5.) A patient takes an initial dose of a nitrate. Which symptom(s) will the nurse expect to occur?
6.) A patient is prescribed a beta blocker. The nurse acknowledges that beta blockers are as effective as antianginals because they do what?
7.) The health care provider is planning to discontinue a patient's beta blocker. Which instruction will the nurse give the patient regarding the beta blocker?
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8.) The beta blocker acebutolol (Sectral) is prescribed for dysrhythmias. The nurse knows that what is the primary purpose of the drug?
9.) A patient who has angina is prescribed nitroglycerin. Which are appropriate nursing interventions for nitroglycerin? (Select all that apply.)
Cardiac
1.) A patient is taking hydrochlorothiazide (HCTZ) 50 mg/day and digoxin (Lanoxin) 0.25 mg/day. The nurse plans to monitor the patient for which potential electrolyte imbalance?
2.) The nurse knows that which statement is correct regarding nursing care of a patient receiving hydrochlorothiazide (HCTZ)? (Select all that apply.)
E. Notify health care provider if patient has had oliguria for 24 hours.
F. Assess for decreased cholesterol and triglyceride levels.
3.) A patient has heart failure, and a high dose of furosemide (Lasix) is ordered. What suggests a favorable response to Lasix?
4.) What does the nurse know to be correct concerning the use of mannitol (Osmitrol) in patients?
5.) What should the nurse do when a patient is taking furosemide (Lasix)?
6.) For the patient taking a diuretic, a combination such as triamterene and hydrochlorothiazide may be prescribed. The nurse realizes that this combination is ordered for which purpose?
7.) The patient has been receiving spironolactone (Aldactone) 50 mg/day for heart failure. The nurse should closely monitor the patient for which condition?
1.) A patient's blood pressure (BP) is 130/84. The health care provider plans to suggest nonpharmacologic methods for the patient. Which should the nurse include in teaching? (Select all that apply.)
2.) A patient has developed mild hypertension. The nurse acknowledges that the first-line drug for treating this patient's blood pressure might be which drug?
3.) An African-American patient has developed hypertension. The nurse is aware that which group(s) of antihypertensive drugs are less effective in African-American patients?
4.) The nurse knows that which diuretic is most frequently combined with an antihypertensive drug?
5.) The nurse is administering a beta blocker to a patient. Which is an important assessment to perform before administration?
6.) Captopril (Capoten) has been ordered for a patient. The nurse teaches the patient that angiotensin- converting enzyme (ACE) inhibitors have which common side effects?
7.) A patient is prescribed losartan (Cozaar). The nurse teaches the patient that an angiotensin II receptor blocker (ARB) acts by doing what?
8.) During an admission assessment, a patient states that she takes amlodipine (Norvasc). The nurse wishes to determine whether the patient has any common side effects of a calcium channel blocker. The nurse asks the patient if she has which signs and symptoms? (Select all that apply.)
1.) A patient is placed on heparin, and the nurse acknowledges that heparin is effective for preventing clot formation in patients who have which disorder(s)? (Select all that apply.)
2.) A patient who received heparin begins to bleed. The nurse anticipates that the health care provider will order which antidote?
3.) A patient is prescribed enoxaparin (Lovenox). The nurse knows that low–molecular-weight heparin has what kind of half-life?
4.) The nurse is teaching a patient about clopidogrel (Plavix). Which information will the nurse include in the patient's teaching plan?
5.) A patient had an orthopedic surgery and is prescribed dalteparin (Fragmin). What would the nurse teach the patient and/or family about this low–molecular-weight heparin (LMWH) before discharge?
6.) A patient is being changed from an injectable anticoagulant to an oral anticoagulant. Which anticoagulant does the nurse realize is administered orally?
7.) A patient is taking warfarin 5 mg/day for atrial fibrillation. The patient's international normalized ratio (INR) is 3.8. The nurse would consider the INR to be what?
8.) Cilostazol (Pletal) is being prescribed for a patient with coronary artery disease. The nurse understands that which is the major purpose for antiplatelet drug therapy?
9.) A patient is to undergo a coronary angioplasty. The nurse acknowledges that which drug is used primarily for preventing reocclusion of coronary arteries following coronary angioplasty?
10.) A patient is admitted to the emergency department with an acute myocardial infarction. Which drug does the nurse anticipate the health care provider to order for prevention of tissue necrosis following blood clot blockage in a coronary artery?
1.) A patient has a serum cholesterol level of 265 mg/dL, triglyceride level of 235 mg/dL, and LDL of 180 mg/dL. What do these serum levels indicate?
2.) The nurse knows that a patient's total cholesterol level should be within which range?
3.) A patient has a low-density lipoprotein (LDL) of 175 mg/dL and a high-density lipoprotein (HDL) of 30 mg/dL. What teaching should the nurse implement for this patient?
4.) Which laboratory test value does the nurse realize can contribute to the development of cardiovascular disease and stroke?
5.) A patient is taking lovastatin (Mevacor). Which serum level is most important for the nurse to monitor?
6.) For what severe skeletal muscle adverse reaction should the nurse observe in a patient taking rosuvastatin (Crestor)?
7.) A patient is taking ezetimibe (Zetia) and asks the nurse how it works. The nurse should explain that ezetimibe does what?
8.) A patient is diagnosed with peripheral arterial disease. He is prescribed pentoxifylline (Trental). What does the nurse realize are the effects of pentoxifylline? (Select all that apply.)
Gastrointestinal
1.) A patient complains of constipation and requires a laxative. In providing teaching for this patient, the nurse reviews the common causes of constipation, including which cause?
2.) A patient with nausea is taking ondansetron (Zofran). She asks the nurse how this drug works. The nurse is aware that this medication has which action?
3.) A patient who has constipation is prescribed a bisacodyl (Dulcolax) suppository. Which explanation will the nurse use to explain the action of bisacodyl?
4.) A patient is using scopolamine (Transderm-Scōp) to prevent motion sickness. About which common side effect should the nurse teach the patient?
5.) When metoclopramide (Reglan) is given for nausea, the nurse plans to caution the patient to avoid which substance?
6.) The nurse is administering diphenoxylate with atropine (Lomotil) to a patient. Which should be included in the patient teaching regarding this medication? (Select all that apply.)
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1.) A patient is diagnosed with peptic ulcer disease. The nurse realizes that which factor is a predisposing factor for this condition?
2.) A student nurse is preparing to administer sucralfate (Carafate) to a patient. Which statement by the student nurse demonstrates understanding of sucralfate's mode of action?
3.) A patient is taking ranitidine (Zantac). What information should the nurse teach the patient about this drug? (Select all that apply.)
4.) When a patient complains of pain accompanying a peptic ulcer, why should the nurse give an antacid?
5.) A patient is taking famotidine (Pepcid) to inhibit gastric secretions. Which side effects of famotidine will the nurse teach the patient? (Select all that apply.)
6.) The patient is taking esomeprazole magnesium (Nexium) for an erosive GERD. Which should the nurse include in patient teaching?
Emergency Drugs
1.) The nurse is administering atropine 0.3 mg IV to a 75-year-old patient with a heart rate of 45, and his heart rate decreases to 38. What is the most likely explanation?
2.) An 80-year-old woman with a hip fracture received morphine 3 mg IV 20 minutes ago. The patient's son runs to the nurses' station and says that his mother is no longer responding to him. What actions should the nurse take?
3.) The nurse is caring for a 21-year-old woman with a closed head injury. Her intracranial pressure is 35 (normal <20). Her serum osmolality is 330. The nurse should anticipate which action?
4.) A dopamine infusion was started in a patient's antecubital vein during resuscitation after cardiac arrest. The electronic infusion device is now sounding an alert for an occlusion. What is the most important immediate concern for the nurse?
5.) Adenosine is ordered for a patient in the emergency department. Immediately after intravenous administration, the nurse observes a short period of asystole on the cardiac monitor that resolves spontaneously. What is the most appropriate initial action for the nurse?
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6.) A patient on the medical-surgical unit has suffered an acute anaphylactic reaction during infusion of an IV antibiotic with hives and bronchospasm. The nurse practitioner has written a number of stat medication orders. What is the priority medication to administer first?
7.) The nurse receives a stat order to administer 50% dextrose solution intravenously to a 1-year-old child with hypoglycemia. How should this medication best be prepared for safe administration to the child?
8.) A 51-year-old woman has been reportedly taking Xanax for a severe anxiety disorder following her mother's death. She was brought into the emergency department because she became unresponsive while at work in an insurance office. Knowing her history, what should the nurse anticipate administering?
9.) A 25-year-old woman was admitted to the emergency department after a successful prehospital resuscitation from cardiac arrest owing to an asthma attack. On arrival, her pulse oximeter reading is 85%. Given her condition, what is the most important initial medication to administer as ordered?
10.) The nurse practitioner orders epinephrine 0.3 mg IM for a severe allergic reaction to a bee sting in an adult patient. Which concentration of epinephrine should the nurse select to administer this particular dose?
11.) The emergency physician orders activated charcoal for a teenage girl who took an intentional overdose of aspirin and several unknown drugs from her parent's medicine cabinet. Upon preparing to administer the activated charcoal by mouth, the nurse notes that the patient has become very somnolent and opens her eyes only to a noxious stimulus. Which action by the nurse is most appropriate at this point?
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12.) While getting dressed to go home after minor outpatient surgery on his leg for removal of a mole, a 62-year-old patient notifies the nurse that he has severe chest pain. He is also diaphoretic and complains of shortness of breath. The surgeon is notified and orders administration of aspirin 325 mg PO while quickly making arrangements to transfer the patient to the emergency department. Which is the best course of action by the nurse? [Show Less]