NURS 3247 Pharmacology - Proctored Assesment
Pharmacology – Proctored Review
A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine
... [Show More] (Synthroid) 0.25 mg
PO daily. After 6 weeks of treatment the nurse dtermines that the medication was effective if
the:
1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL
2) Total t4 level is 2 mcg/dL
A nurse providing teaching to a client who has just been prescribed prazosin (Minipress) which
of the following client statement indicates understanding of teaching:
1) I will not use a salt substitute while taking meds
2) I will move slowly from sitting to standing to prevent falls
A nurse is providing teaching to a patient who is prescribed phenytoin (Dilantin). Which
statement by the patient indicates further teaching:
1) I should expect a rash to develop
2) I may develop hair or face or chest
A nurse is receiving a telephone prescription for an antibiotic from a client's provider. Which of
the following is the nurse required to do:
3) Read the prescription back to the provider after transcribing
4) Write the trade name for the prescribed medicine
A nurse is providing teaching to an adolescent and her family regarding a new prescription of
phenytoin (Dilantin) for a newly diagnosed seizure disorder. Which of the following client
statements indicates the understanding of the teaching:
1) I will keep a seizure frequency chart
2) I will skip a dose if I am experiencing nausea
A nurse is caring for a client who has heart failure and is receiving furosemide (Lasix) and
digoxin (Lanoxin). Routine laboratory results reveal a potassium level of 2.6 mEq/L. Which of the
following actions should the nurse take first:
1) Apply a cardiac monitor
2) Provides foods high in potassium
A nurse administers ceftazidime (Fortaz) to a client who has a severe penicillin allergy. Which of
the following client findings requires an incident report:
1) The client is also taking linsinophrel (Prinivil)
2) The client reports shortness of breath
A nurse is providing teaching to a female client who has been newly diagnosed with a seizure
disorder and has begun phenytoin (Dilantin). The nurse should tell the client that phenytoin can
decrease the effectiveness of which of the following:
1) Ethunyl estradiol/desogestrel (Cyclessa)
2) Fluroxetine (Prozac)
A nurse providing teaching to a client who is diagnosed with migrane headaches. The client is
prescribed ergotamine (Ergostat) sublingual (SL). Which of the following should the nurse
include in her instructions:
1) Take 1SL tablet three times a day before meals
2) Take 1SL tablet at onset of migrane
A nurse is reviewing a client's daily laboratory findings before administering 0.125 mg of digoxin
(Lanoxin). The client's serum digoxin level is 0.7 ng/mL. Which of the following actions should
the nurse take:
1) Give the medication
2) Request a dose increase
A nurse is planning to provide medication education for a client who will begin a course of
therapy with metronidazole (Flagyl). Which of the following should the nurse instruct the client
to avoid during the course of therapy:
3) Coffee
4) Beer
A nurse is teaching a client who has heart failure about a new prescription for captopril
(Capoten). Which of the following statements by the client indicates a need for further teaching:
3) I will take the medication 1 hr before my meals
4) I will use a salt substitute with my meals
A client is experiencing acute angle closure glaucoma and IV mannitol (Osmitrol) 25% is
prescribed. Which of the following client findings should the nurse recognize as being the best
indication that the medication is achieving it's therapeutic effect:
3) Decrease in intraocular pressure
4)Lung fluids clear to ausculatation
A nurse is educating a client who has a new prescription for simvastatin (Zacor). Which of the
following instructions should the nurse include in the teaching plan: (Select all that apply):
1) Report muscle pain to provider
2) Do not take the medication with grapefruit juice
3) Take the medication in the early morning
4) Minimize intake of alcoholic beverages
5) Expect therapy with this medication to be life long
A client taking IV heparin and oral warfarin (coumadin) for deep thrombosis. The client aPTT is
4x the normal value and his INR is 2. Which of the following actions should the nurse plan to
take:
1) Decrease the heparin
2) Increase the warfarin
The nurse is caring for a client who is in labor. The client is receiving oxytocin (pitocin) by
continuous IV infusion, piggy backed into a maintenance IV solution. The external FHR monitor
indicates late decelerations. Which of the following actions should the nurse take first:
1) Turn the client to side lying position
2) Discontinue the client's IV meds
A nurse is providing teaching to a client taking bupropion (Zyban) as an aid to quit smoking. For
which of the following side effects should the nurse assess the client:
3) Insomnia
4) Tinnitus
A nurse is teaching a client about the use of resedronate (Actonel) to treat osteoporasis. Which
of the following client statements indicates a need for further teaching:
3) I need to set up or stand after taking the risedronate
4) I need to take the risdronate with food
A nurse is caring for a client who is receiving haloperidol (Haldol). For which of the following
adverse effects should the nurse be observing:
1) vomiting
2) Akathesia
A nurse is caring for a client who is receiving oprelvekin (Interleukin ll). which should the nurse
document to indicate the effectiveness of the therapy:
1) Increased platelet count
2) Increased RBC count
A nurse is administering baclofen (Lioresal) for a client with a spinal cord injury. Which of the
following should the nurse document as a therapeutic outcome:
1) Increase in seizure threshold
2) Decrease flexor & extension spasticity
A nurse is assessing a client who is receiving epoetin alfa (Procit) to treat anemia. For which
should the nurse monitor related to this medication:
1) Paresthesias
2) Increased BP
A nurse is planning teaching for a client who has depression and is to start a new prescription
for tranylcypromine (Parnate). Which should be included in teaching:
1) Avoid eating citrus fruits while taking this medication
2) Move slowly when changing to a standing position
Provide teaching new prescription: exenatide (Byetta) for Type 2 Diabetes. What should the
nurse monitor and report:
1) Abdominal pain
2) Increased thirst
A nurse is reveiwing lab results, for a patient who has chronic asthma and is taking prednisone
(Deltasome) every other day. Which of the following lab values should the nurse report to the
doctor:
3) Blood glucose 200 mg/dL
4) BUN 14 mg/dL
A nurse is caring for a client receiving zidovudine (Retrovir) for which of the following lab results
should the nurse prepare to monitor:
3) Serum creatine
4) Hemoglobin
A client informs the nurse at the primary care providers office that he received a prescription for
timolol (timoptic) to treat glaucoma. Which of the following in the client's history should
concern you:
3) The client has a history of bradycardia
4) The client reports that he is taking loratadine (Claritan)
A mom of a newborn asks the nurse when her newborn should receive his 1st diptheria,
tetanus, and pertusis vaccine (DTAP). Which of the following should the nurse say:
1) Birth
2) 2 months
A nurse is preparing to administer warfarin (coumadin) to a client diagnosed with atrial
fibrillation. Which action should the nurse take before administering warfarin:
1) Check INR results
2) Monitor the aPTT level
A nurse caring for a client diagnosed with sickle cell anemia who is taking hydroxyurea (Droxia).
Which findings should the nurse report- select all that apply:
1) hemoglobin 4.2 g/dL
2) Hematocrit 42%
3) RBC 4,700,000/ mm3
4) Platelets 75,000/mm3
5) Neutrophils 1,400 /mm3
A nurse assesses a patient with chronic back pain who is receving 650 mg acetaminophen
(Tylenol) every 4 hours for pain. PCP has prescribed oxycodone/acetaminophen (Percocet) every
4 to 6 hours PRN for breakthrough pain. Which action should the nurse take:
3) Place the client on seizure precautions
4) Notify the PCP
A nurse is teaching a patient who has a peptic ulcer disease and is to start a new prescription for
sucralfate (Carafate). The nurse explains to the patient this medication:
3) Forms a protective barriers over ulcers
4) Treats ulcers by eradicating H. pylor
Which of the following statements made by a client after a teaching session about Warfarin
(Coumadin) indicates a need for further teaching:
1) I may take aspirin as needed for pain
2) I should limit the amount of green, leafy vegetables
A nurse is caring for a patient who has pneumonia. The patient tells the nurse that she is
pregnant, but has not told her provider. Which of the following medication orders should the
nurse question:
1) Acetaminophen (Tylenol)
2) Doxycycline (Doxycin)
A nurse is providing teaching to a patient who has hypertension and is to start a new
prescription for lisinopril (Zestril). For which of the following should the nurse instruct the client
to monitor and report to the PCP:
3) Facial Flushing
4) Dry cough
A nurse caring for the following patient with acute ST elevation myocardinal infarction. The
patient is receiving nitroglycerin (Nitro-bid IV) by continuous IV infusion to maintain a systolic
blood pressure between 130-10 mmHg:
1) Increase the dose when the Systolic BP is 120 mmHg
2) Increase the dose when the Systolic BP is 160 mmHg
Older adult taking procainamide (Pronestyl) is admitted to ER with an acute myocardinal
infarction and ventricular premature beats. Which finding should indicate to the nurse to
withold medication and notify PCP:
1) Drowsiness
2) A QRS widening increase than 50%
A nurse is caring for a client who is taking tamoxifen (Nolvadex) for treatment of breast cancer.
The nurse should inform the client that which of the side effects can develop:(Slect all that
apply)
1) Bradycardia
2) Menstrual irregularities
3) Petechia
4) Hot flashes
5) Vaginal discharge
A nurse is providing teaching to a patient with chronic asthma, is prescribed beclomethsdone
(QVAR). What instructions should be included in the nursing care plan:
1) Use inhaler as soon as asthma attack begins
2) Take extra Vitamin B & C when using medication
A client with history of hypertension tells the nurse that he uses over-the counter oral
decongestant for nasal congestion. The nurse should advise client that decongestions?
3) Can constrict blood vessels
4) Are less effective than antihistamines
A nurse is providing teaching for a patient with acute cystitus and is prescribed phenazopyridine
HCL (Pyridium). Which side effect will be normal for the patient to see:
1) Urine will turn red-orange color
2) A mild fever
A patient has been prescribed trimethoprim/sulfamethoxazole (Bactrum DS). Which of the
following should the nurse reort:
3) Photosensitivity
4) Vescular, crusty rash
A client has been taking propylthiouracil (PTU) for 4 weeks- what should an outcome be:
3) Decrease heart rate
4) Increase body temp
A nurse instructing on appropriate placement of the client's nitroglycerin transdermal patch
(Minitran) understands teaching with this statement:
1) I should apply the patch to an area of body with minimal fat tissue
2) I will take the patch off right after my evening meal
A nurse is to administer a new prescription for amoxicillin/clavulanic acid (Augmentin) IV bolus.
The client tells the nurse allergy to penicillin. Which should be done first:
3) Withhold the medication
4) Inform the pharmacist of allergy to penicillin
A nurse providing discharge teaching for patient has a prescription for morphine. The nurse
should:
3) Increase fiber intake
4) Increase dosage to relieve pain
A nurse is monitoring a patient who has been prescribed amphoterian B (Fungizone)
intermittent IV bolus for histoplasmosis. What adverse effects should you notify PCP:
1) Bradycardia
2) Fever
A patient has been receiving aspirin for treatment of arthritis. Which symptom should indicate
the client beginning to exhibit salicylism:
3) Excessive bruising
4) Tinnitus
A nurse is caring for a patient who has cancer and is experiencing breakthrough pain every 6 to
8 hours. The client report pain level of 8 on a scale of 0 to 10. Which of the following analgesics
should the nurse anticipate administering:
3) Celecoxib (Celebrax)
4) Hydromorpine (Dilaudid)
A nurse is caring for a school age child prescribed methylphenidate (Ritalin) for ADHD. The nurse
has initiated interventions to minimize adverse effects. Which of the following indicates a
successful intervention:
1) Increase BP
2) Maintains age- appropriate weight
A nurse is instructing a client who experiences migranes and is starting oral sumatriptan
(Imitrex) therapy. Which of the following should the nurse include in teaching:
1) Take the medication 1x daily to prevent migrane attacks
2) Use the medication as soon as migrane symptoms appear
Nurse caring for postoperative patient with PCA of morphine sulfate. The nurse assesses a
respiratory rate of 10/ min and is unable to arouse the patient with verbal or tactile stimulation.
Which of the following actions should the nurse first take:
3) administer naloxone (Narcan) IV to the client
4) Notify the primary of the findings
A patient diagnosed with acute bronchitis is beginning a short course of prednisone (Deltasone)
therapy. The patient asks the nurse to give him the required vaccinations because he is joining
the peace corp. The nurse appropriately responds by stating, "You should":
1) Wait until you have completed your medication therapy before receiving the vaccinations
2) Wait until after you have taken this medication for a few days
A nurse is providing teaching to a client regarding the administration of ferrous sulfate (Feosol).
Which of the following instructions should the nurse include in her teaching:
3) Take the tablet on an empty stomach
4) Call your provider if you begin to bruise easily
A nurse is providing teaching to a client who has a new prescription for phenytoin (Dilantin).
Which of the following statements by the client indicates an understanding of the teaching:
3) I should let my dentist know that I'm taking this medication
4) I should expect to experience some unusual type movement when taking Dilantin
A nurse is caring for an older adult patient who is taking ranitidine (Zantac) for GERD> For which
of the following findings should the client be instructed to monitor and report to provider:
3) Clay colored stools
4) Green sputum
A nurse is assessing a patient who is taking oral contraceptives. Which of the following
medications will interfere with the effectiveness of the oral contraceptives:
1) Warfarin (Coumadin)
2) carbamazepine (Tegretol)
A nurse is teaching a patient with tuberculosis about the adverse effects of isoniazid (INH). The
nurse restricts the client to notify the PCP immediately if which of the following occurs:
3) Yellowish skin tones
4) Headache
A nurse is reinforcing teaching to a 17 year old female patient who has severe acne regarding
the use of isotretinoin (Accutane). Which of the following side effects is the priority side effect
to report to the PCP:
3) Back pain
4) Feelings of isolation
A nurse caring for a client who was admitted to the hospital with congestive heart failure (CHF)
and is taking digoxin (Lanoxin) 0.25 mg daily .he patient refused breakfast and is complaining of
nausea and generalized weakness. Which of the following actions should the nurse perform 1st:
1) Check the patient's vital signs
2) Request a dietitian consult
A nurse is caring for a patient who is hospitalized with active pulmonary tuberculosis and is to
be started on ethambutol (myambutol) therapy. The nurse should understand that which of the
following should be monitored:
1) Visual Activity
2) Skin color
A clinic nurse is giving instructions to a mother on the proper technique of applying ointment to
her pre-school-age child. Who has conjunctivitis. Which should the nurse include in the
instructions:
3) Discard the first bead of ointment before each application
4) Instruct your client to squeeze his eyes shut following application
A nurse enters an older adult patient's room to insert a saline lock. The client ask the nurse,
'Why do i need that, I am drinking plenty of fluids?" Which of the following responses by the
nurse is appropriate?"
3) We give all our medications IV in this unit
4) The provider has prescribed antibiotics therapy to be administered IV every 6 hours
A nurse is caring for a patient who has erectile dysfunction and is interested in taking sildenafel
(Viagra). The nurse informs the patient that sildenfil is contraindicated due to the fact that the
client also takes which one of the following medications:
1) Isosorbide (Isordel)
2) Phenytoin (Dilatin)
A nurse reported to the nurse manager that another staff member was observed signing out
meperidine hydrochloride (Demerol), which was not administered to the patient. The nurse
manager should know that potential opiate abuse by the employees may be manifested by
which of the following symptoms:
1) tremors
2) rhinorrhea
A nurse is caring for a patient who is taking clarithyromycin (Biaxin). The nurse includes a
diagnosisof "risk for altered sensory perception" in the client's plan of care. This is appropriate
because many client's on clarithromycin have an altered sense of which of the following:
1) Smell
2) taste
A nurse is caring for a client who has asthma and is prescribed chewable mortelukast (Singular).
The nurse should instruct the child's parent to administer the medication:
1) Daily at bedtime
2) Before any activity
A nurse is assessing a client who comes to the clinic for a seasonal influenza vaccine. The client
says he read about an influenza vaccine that is given as a nasal spray and wants to receive it.
Which of the following is a contradiction for the patient to receiving the live attenuated
influenza vaccine (LAIV)?
1) Just turned 62
2) Smokes one pack of cigarettes a day
A nurse is caring for a client who is receiving chlorpromazine (Thorazine) and is given a pass to
attend a family outing on a sunny day. Which of the following is the most important for the
nurse to include in the client's teaching about the side effects of chlorpromazine?
1) Wear a hat and long sleeved shirt
2) Suck on hard candies
A nurse is reviewing a client's admission record. The nurse notes that there are prescriptions for
several medications. Which of the following factors should the nurse recognizes is of primary
consideration when determining the schedule of administration:
1) Institutional policies regarding routine medication administration times
2) Specific characteristics of the medications
A client has a history of myocardinal infarction (MI) is precribed aspirin (Ecotrin) 325 mg. The
nurse correctly understands that the aspirin is ordered due to its action as a:
3) Antiplatelet aggregate
4) Antipyretic
A home health nurse is reviewing the medication list of an older adult patient who reports
falling a couple of times over the past week. Which of the following meds should the nurse
suspect is contributing to the client's falls:
1) Alprazolam (Xanax)
2) Acetaminophen (Tylenol)
A nurse is caring for an older adult client who is hospitalized. Which of the following medication
is likely to put the client at risk for orthostatic hypotension. (Select all that apply):
1) Furosemide (Lasix)
2) Telmisartan (Micardis)
3) Phenelzine sulfate (Nardil)
4) Clopidogrel (Plavix)
5) Atorvastatin (Lipitor)
A nurse is caring for a client who is receiving nifedipine (Procardia). The nurse checks the client's
blood pressure before administering medication and reports 98/58. Which of the following
actions should the nurse first take:
3) Document the patient's blood pressure
4) Recheck the client's blood pressure
A nurse is caring for an older adult client who has rheumatoid arthritis and is taking aspirin
(Bufferin) 650 mg every 4 hours. Which of the following diagnostic tests should the nurse
monitor to evaluate the effectiveness of this medication:
3) Antinuclear antibody (ANA)
4) Erthrocyte sedimentation rate (ESR)
A nurse is caring for several patients who have bipolar disorder. The nurse should recognize that
which of the following medications are appropriate for treating this condition (Select all that
apply):
1) paraoxetine (Paxil)
2) lithium (Lethane)
3) tranylcypromine (Parnate)
4) valproic acid (Depakota)
5) phenytoin (Dilantin)
6) carbamazepine (tegretol)
A nurse is assessing a client who has numerous bruises on his upper extremities. The patient
reports that he has taken warfarin (coumadin) daily for the past 3 months. Which of the
following statements by the client indicates the client needs further teaching:
1) I have started taking ginger root to treat my joint stiffness
2) I take tylenol whenever I have a headache
A nurse is caring for a client with nausea. The client is prescribed intravenous metaclopramide
(Reglan) as needed. The nurse knows that Reglan is an effective antimetic because it
1) Promotes gastric emptying
2) Decrease gastric acid secretions
A nurse is caring for a patient with chronic renal failure and states she has heartburn. Prescribes
aluminum hydroxide (Amphojel). The patient asks the nurse why cant i just take the antacide
magadrate (Reopan) my husband has at home. The nurse explains to the client that aluminum
hydroxide is the preferred antacid because it lowers which of the following:
1) Serum phosphorus levels
2) Serum potassium levels
A nurse is planning teaching for a child who has been prescribed fluticasone propionate
(Flovent) for treatment of chronic asthma. The nurse plans to teach the child to use a spacer to
minimize the risk for which of the follo [Show Less]