Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 1. The nurse answers a patient's call light and finds the patient sitting up in bed
... [Show More] and requesting pain medication. What will the nu rse do first? A. Check the orders and give the patient the requested pain medication B. Provide comfort measures to the patient C. Assess the patient's pain and pain level D. Evaluate the effectiveness of previous pain medications 2. The nurse is preparing to administer a transdermal patch to a patient and finds that the patient already has a medication patch on his right upper chest. What will the nurse do? A. Remove the old medication patch and notify the health care provider B. Apply the new patch without removing the old one C. Remove the old patch and apply the new one in the same spot D. Remove the old patch and apply the new patch to a different clean area 3. A patient is complaining of severe pain and has orders for morphine sulfate. The nurse knows that the route that would give the slowest pain relief is which route? A. IV B. PO C. Subcutaneous D. IM 4. A patient is recovering from an appendectomy. She also has asthma and allergies to shellfish and iodine. To manage her postoperative pain, the physician has prescribed hydromorphone (Dilaudid). Which vital sign is of greatest concern? A. Temperature B. Respirations C. Pulse D. Blood pressure Created on:06/16/2019 Page 1Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 5. The patient is diagnosed with Parkinson's disease and has been started on a dopaminergic replacement drug therapy with carbidopa-levodopa, it is important for the nurse to A. assess the patient for dizziness and syncope when the patient is walking B. administer the medication first thing in the morning C. administer the medication on an empty stomach D. remove protein from the patient's diet 6. Which drug will the nurse anticipate administering to a patient experiencing a benzodiazepine overdose? A. Flumazenil B. Narcan C. Methadone D. Antabuse 7. Which statement is important for the nurse to include when teaching a patient about disulfiram (Antabuse) therapy? A. This medication will cure your alcoholism if you take as directed B. This medication will cause your blood pressure to get very high if you drink alcohol after taking it C. "You cannot drink alcohol for at least 3-4 days after taking this medication D. "If you miss a dose of Antabuse, double up the next time it is due" 8. A patient on a dobutamine drip starts complaining that her IV line "hurts really bad" The nurse on assessing the site notices that it is red, swollen and cool to touch. What will the nurse do first? A. Slow the infusion rate B. Stop the infusion C. Inject the area with phentolamine D. Notify the health care provider 9. A nursing is planning care for a client who is receiving furosemide (lasix) IV for peripheral edema. Which of the Created on:06/16/2019 Page 2Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 following interventions should the nurse include in the plan of care? (Select all that apply) A. Assess for tinnitus B. Monitor serum potassium C. Elevate head of bed before ambulation D. Report urine output of 50mL/hr E. Recommend eating a banana daily 10.A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply) A. Simvastain (Zocor) B. Hydrochlorothiazide (HCTZ) C. Dilantin (Phenytoin) D. Clonidine (Catapres) E. Nitroglycerin (Nitrostat) 11.A nurse is teaching a client about a new medication, verapamil (Calan), for hypertension. What information should be include in teaching? A. Increase the amount of dietary fiber in the diet B. Drink grapefruit juice daily to increase vitamin C intake C. Decrease the amount of calcium in diet D. Withhold food for 1 hour after the medication is taken 12.When planning care for an assigned patient, the nurse identifies the outcome of “Patient will be able to safely self-administer enoxaparin (Lovenox) subcutaneously upon discharge.” Which method is best for the nurse to use in evaluating the patient’s achievement of this outcome? A. Demonstrate the correct administration procedure to the patient. B. Give the patient detailed written instructions illustrating the procedure. C. Observe the patient’s return demonstration of the administration procedure. D. Ask the patient to verbalize the correct administration procedure step by step. Created on:06/16/2019 Page 3Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 13.During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do first? A. Discontinue the infusion immediately. B. Reduce the infusion rate gradually until the adverse effects subside. C. Administer the medication by rapid IV infusion to reduce these effects. D. Nothing; these are expected side effects of this medication. 14.A patient is taking nystatin (Mycostatin) oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate? A. “Chew the lozenges until they are completely dissolved.” B. “Let the lozenge dissolve slowly and completely in your mouth without chewing it.” C. “Rinse your mouth with water before taking the inhaler.” D. “Rinse your mouth with mouthwash after taking the inhaler.” 15.A patient with active HIV has been taking zidovudine (Retrovir). Which is potential adverse effect may limit the length of time this medication can be taken? A. Lactic Acidosis B. Bone marrow suppression C. Hepatomegaly D. Fatigue 16.A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching? A. Report clear-colored sputum to the prescriber. B. Force fluids to help loosen and liquefy secretions. C. Avoid driving a car or operating heavy machinery because of the sedating effects. D. Report symptoms that last longer than 2 days. Created on:06/16/2019 Page 4Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 17.A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient’s medication administration record and recognizes that which adjuvant medication is most appropriate for this type of pain? A. Antidepressant B. Anticonvulsant C. Corticosteroid D. Local anesthesia 18.The nurse on educating the patient on the common side/adverse effects of opioids will educate on which of the following: (Select all that apply) A. decreased respirations B. heartburn C. constipation D. nausea E. insomnia 19.A patient who is receiving high-dose chemotherapy with methotrexate is also receiving leucovorin. The purpose of the leucovorin is to: A. produce an additive effect with the methotrexate by increasing its potency against the cancer cells. B. reduce the incidence of cardiomyopathy caused by the methotrexate. C. reduce the Bone Marrow Suppression caused by the methotrexate. D. add its antiinflammatory effects to the treatment regimen. 20.A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen? A. Increased bleeding tendencies B. Increased chance for GI bleeding C. Increased nephrotoxic effects D. Reduced antiinflammatory effects of the NSAID Created on:06/16/2019 Page 5Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 21.The nurse should teach the patient taking an oral corticosteroid to take the medication at what time? A. 8:00 am B. 8:00 pm C. 12 noon D. 5:00 pm 22.A patient wants to take garlic to improve his cholesterol levels. Which condition would be a contraindication? A. Hptertension B. Scheduled surgery C. Sinus infection D. Bowel obstruction 23.When converting from IV heparin to oral warfarin (Coumadin) therapy, the prescriber monitors which of the following to determine the next appropriate dose of warfarin? A. Platelet count B. aPTT C. Red blood cell count D. PT/INR 24.A patient with extremely high blood pressure is in the emergency department. The physician will order therapy with nitroglycerin to manage the patient's blood pressure. Which form of nitroglycerin is most appropriate? A. Sublingual spray B. Transdermal patch C. Oral capsule D. IV infusion 25.A nurse is caring for a client who is to receive liquid medications via a gastrostomy tube. The client is prescribed Created on:06/16/2019 Page 6Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 phenytoin 250 mg. The amount available is phenytoin oral solution 25 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 50 mL Correct Rationale: Ratio and Proportion STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 3: What is the dose available? Dose available = Have 25 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL STEP 6: Set up an equation and solve for X. Have/Quantity = Desired/X 25 mg/5 mL = 250 mg/X mL X = 50 STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. Desired Over Have STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 3: What is the dose available? Dose available = Have 25 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL STEP 6: Set up an equation and solve for X. Desired x Quantity/Have = X 250 mg x 5 mL/25 mg = X mL 50 = X STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. Dimensional Analysis STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the quantity of the dose available? 5 mL STEP 3: What is the dose available? Dose available = Have 25 mL STEP 4: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 5: Should the nurse convert the units of measurement? No STEP 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion(Desired) x Desired/ X mL = 5 mL/25 mg x 250 mg/ X = 50STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. InCorrect Rationale: Ratio and Proportion STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 3: What is the dose available? Dose available = Have 25 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL STEP 6: Set up an equation and solve for X. Have/Quantity = Desired/X 25 mg/5 mL = 250 mg/X mL X = 50 STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. Desired Over Have STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 3: What is the dose available? Dose available = Have 25 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL STEP 6: Set up an equation and solve for X. Desired x Quantity/Have = X 250 mg x 5 mL/25 mg = X mL 50 = X STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to Created on:06/16/2019 Page 7Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. Dimensional Analysis STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the quantity of the dose available? 5 mL STEP 3: What is the dose available? Dose available = Have 25 mL STEP 4: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 5: Should the nurse convert the units of measurement? No STEP 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion(Desired) x Desired/ X mL = 5 mL/25 mg x 250 mg/ X = 50STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. 26.A nurse is educating a group of clients about the contraindications of warfarin therapy. Which of the following statements should the nurse include in the teaching? A. "Clients who have glaucoma should not take warfarin." Rationale: Liver disease is a contraindication for warfarin therapy. B. "Clients who have rheumatoid arthritis should not take warfarin." Rationale: Thrombocytopenia is a contraindication for warfarin therapy. C. "Clients who are pregnant should not take warfarin." Rationale: Warfarin therapy is contraindicated in the pregnant client because it crosses the placenta and places the fetus at risk for bleeding. D. "Clients who have hyperthyroidism should not take warfarin." Rationale: Peptic ulcer disease is a contraindication for warfarin therapy 27.A nurse is reviewing the medication list for a client who has a new prescription for warfarin. The nurse should recognize that which of the following medications is incompatible with warfarin? A. Furosemide Rationale: Furosemide can cause potassium loss and increase the risk for digoxin toxicity when used concurrently with digoxin. B. Alprazolam Rationale: Alprazolam, used with sedative hypnotic medications, can increase the risk for CNS depression. C. Vitamin K Rationale: These two medications are not compatible. Vitamin K antagonizes the action of warfarin and is the antidote for warfarin toxicity. Created on:06/16/2019 Page 8Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 D. Vitamin A Rationale: Oral contraceptives can increase vitamin A levels. 28.A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instructions should the nurse include in the teaching? A. Mild nosebleeds are common during initial treatment. Rationale: Warfarin, an anticoagulant, increases the client's risk for bleeding. The nurse should instruct the client to stop the medication and notify the provider for manifestations of bleeding. B. Use an electric razor while on this medication. Rationale: Warfarin, an anticoagulant, increases the client’s risk for bleeding. The nurse should teach the client safety measures, such as using an electric razor, to decrease the risk for injury and bleeding. C. If a dose of the medication is missed, double the dose at the next scheduled time. Rationale: Warfarin, an anticoagulant, should be taken at the same time each day and the client should not adjust the dose. Doubling a dose increases the client's risk for bleeding. D. Increase fiber intake to reduce the adverse effect of constipation. Rationale: Warfarin can cause diarrhea. 29.A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching? A. "Place one tablet under your tongue every 5 minutes for 30 minutes to relieve chest pain." Rationale: The client should place one tablet under the tongue every 5 min for 15 min, for 3 total doses, to relieve chest pain. B. "Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries." Rationale: Nitroglycerin relaxes the blood vessels, which increases blood and oxygen supply to the heart. Nitroglycerin does not dissolve blood clots. C. "You can store the bottle of tablets in your bathroom medicine cabinet." Rationale: Nitroglycerin loses its effectiveness after 6 months or after exposure to light or moisture. The client should not store the tablets in the bathroom. D. "Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart." Rationale: Nitroglycerin is a nitrate medication that increases collateral blood flow, redistributes blood flow toward the subendocardium, and dilates the coronary arteries. Created on:06/16/2019 Page 9Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 30.A nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include in the teaching? A. Apply a new transdermal patch once a week. Rationale: The client should apply a new patch each day, not once a week. B. Apply the transdermal patch in the morning. Rationale: The client should apply the patch every morning and leave it in place for a 12 to 14 hr, then remove it in the evening. C. Apply the transdermal patch in the same location as the previous patch. Rationale: The client should rotate the sites used for patch placement to avoid areas of local skin irritation. D. Apply a new transdermal patch when chest pain is experienced. Rationale: The transdermal route of nitroglycerin has a delayed onset of action, making it suitable for prophylaxis use but not for immediate relief of chest pain. 31.A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? A. "A headache is an indication of an allergy to the medication." Rationale: Allergic reactions typically manifest as itching and a rash, and if worsening, laryngeal edema and bronchospasm. B. "A headache is an expected adverse effect of the medication." Rationale: The vasodilation nitroglycerin induces increases blood flow to the head and typically results in a headache. C. "A headache indicates tolerance to the medication." Rationale: With tolerance, the client needs more of the medication to achieve a therapeutic response. A headache is not a sign of this phenomenon. D. "A headache is likely due to the anxiety about the chest pain." Rationale: This is a nontherapeutic communication technique and offers the nurse's opinion about the cause of the headache rather than a factual statement. 32.A patient has an order for the monoclonal antibody adalimumab (Humira). The nurse notes that the patient does not have a history of cancer. What is another possible reason for administering this drug? Created on:06/16/2019 Page 10Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 A. Severe anemia B. Rheumatoid arthritis C. Thrombocytopenia D. Osteoporosis 33.A patient who has received chemotherapy has a critically low platelet count. The nurse expects which drug or drug class to be used to stimulate platelet cell production? A. filgrastim (Neupogen) B. Interferons C. oprelvekin (Neumega) D. epoetin alfa (Epogen) 34.A patient asks about his cancer treatment with monoclonal antibodies. The nurse tells him that which is the major advantage of treating certain cancers with monoclonal antibodies? A. They will help the patient improve more quickly than will other antineoplastic drugs. B. They are more effective against metastatic tumors. C. Monoclonal antibodies target certain tumor cells and bypass normal cells. D. There are fewer incidences of opportunistic infections with monoclonal antibodies. 35.The nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy. Which is considered the principal early sign of infection? A. Fever B. Diaphoresis C. Tachycardia D. Elevated white blood cell count 36.A patient has used enteric aspirin for several years as treatment for osteoarthritis. However, the symptoms are now worse and she is given a prescription for a nonsteroidal antiinflammatory drug (NSAID) and misoprostol (Cytotec). The patient asks the nurse, “Why am I now taking two pills for arthritis?” What is the nurse’s best response? Created on:06/16/2019 Page 11Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 A. “Cytotec will also reduce the symptoms of your arthritis.” B. “Cytotec helps the action of the NSAID so that it will work better.” C. “Cytotec reduces the mucous secretions in the stomach, which reduces gastric irritation.” D. “Cytotec may help to prevent gastric ulcers that may occur in patients taking NSAIDs.” 37.A mother brings her toddler into the emergency department and tells the nurse that she thinks the toddler has eaten an entire bottle of chewable aspirin tablets. The nurse will assess for which most common signs of salicylate intoxication in children? A. Photosensitivity and nervousness B. Tinnitus and hearing loss C. Acute gastrointestinal bleeding D. Hyperventilation and drowsiness 38.The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which instruction will the nurse include during the teaching session? A. “Fluids should be restricted while on colchicine therapy.” B. “Take colchicine with meals.” C. “The drug will be discontinued when symptoms are reduced.” D. “Call your doctor if you have increased pain or blood in the urine.” 39.An elderly patient tells the nurse that he uses aspirin for “anything that hurts.” The nurse will assess for which most common signs of chronic salicylate intoxication in adults? A. Photosensitivity and nervousness B. Tinnitus and hearing loss C. Acute gastrointestinal bleeding and anorexia D. Hyperventilation and central nervous system (CNS) effects 40.The nurse is reviewing the therapeutic effects of nonsteroidal antiinflammatory drugs (NSAIDs), which include which effect? Created on:06/16/2019 Page 12Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 A. Anxiolytic B. Sedative C. Antipyretic D. Antimicrobial 41.A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which condition? A. Lyme disease B. Toxoplasmosis C. Systemic lupus erythematosus D. Intestinal tapeworms 42.A patient has an infestation with flukes. The nurse anticipates the use of which drug to treat this infestation? A. praziquantel (Biltricide) B. pyrantel (Pin-X) C. metronidazole (Flagyl) D. ivermectin (Stromectol) 43.When monitoring patients on antitubercular drug therapy, the nurse knows that which drug may cause a decrease in visual acuity? A. rifampin (Rifadin) B. isoniazid (INH) C. ethambutol (Myambutol) D. streptomycin 44.A young adult calls the clinic to ask for a prescription for “that new flu drug.” He says he has had the flu for almost 4 days and just heard about a drug that can reduce the symptoms. What is the nurse’s best response to his request? A. “Now that you’ve had the flu, you will need a booster vaccination, not the antiviral drug.” Created on:06/16/2019 Page 13Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 B. “We will need to do a blood test to verify that you actually have the flu.” C. “Drug therapy should be started within 2 days of symptom onset, not 4 days.” D. “We’ll get you a prescription. As long as you start treatment within the next 24 hours, the drug should be effective.” 45.A patient is receiving aminoglycoside therapy and will be receiving a beta-lactam antibiotic as well. The patient asks why two antibiotics have been ordered. What is the nurse’s best response? A. “The combined effect of both antibiotics is greater than each of them alone.” B. “One antibiotic is not strong enough to fight the infection.” C. “We have not yet isolated the bacteria, so the two antibiotics are given to cover a wide range of microorganisms.” D. “We can give a reduced amount of each one if we give them together.” 46.The nurse is administering a vancomycin (Vancocin) infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug’s administration? A. Monitoring blood pressure for hypertension during the infusion B. Discontinuing the drug immediately if red man syndrome occurs C. Restricting fluids during vancomycin therapy D. Infusing the drug over at least 1 hour 47.The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct? A. “Avoid direct sunlight and tanning beds while on this medication.” B. “Milk and cheese products result in increased levels of tetracycline.” C. “Antacids taken with the medication help to reduce gastrointestinal distress.” D. “Take the medication until you are feeling better.” 48.The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate? A. It is indicated for the treatment of acute bronchospasms. Created on:06/16/2019 Page 14Detailed Answer Key Pharmacology Proctored Exam_Cloned_Assessment 1 B. It needs to be used with a spacer for best results. C. Patients need to avoid drinking water for 1 hour after taking this drug. D. It is used for prevention of bronchospasms. 49.After receiving a nebulizer treatment with a beta agonist, the patient complains of feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse’s best response? A. “This is an expected adverse effect. Let me take your pulse.” B. “The next scheduled nebulizer treatment will be skipped.” C. “I will notify the physician about this adverse effect.” [Show Less]