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RN Pharmacology Final Exam
with Complete Solution
2024/25 Update
A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication? A. One B. Two C. Three D. Four {{Correct Ans- A. Medications with long half-lives remain at their therapeutic levels between doses for long periods of time. The nurse should expect to administer this medication once a day. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.) A. Increased renal secretion B. Increased medication-metabolizing enzymes C. Liver failure D. Peripheral vascular disease E. Concurrent use of medication the same pathway metabolizes {{Correct Ans- : C. Liver failure decreases metabolism and thus increases the concentration of a medication. This requires decreasing the dosage. E. When the same pathway metabolizes two medications, they compete for metabolism, thereby increasing the concentration of one or both medications. This requires decreasing the dosage of one or both medications.
A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply.)
a blood specimen. C.Ask the client to pr ovide a urine specimen after the next dose of medication. D.Administer the medication,and obtain a blood specimen 30 min late {{Correct Ans- A. To verify trough levels of a medication, the nurse should obtain a blood specimen immediately before administering the next dose of medication. A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines? (Select all that apply.) A.maintain skill competency. B.Determine the dosage. C. monitor for adverse effects. D.Safeguard medications. E.Identify the client's diagnosis {{Correct Ans- A.maintaining skill competency and using appropriate administration techniques are legal responsibilities of the nurse C. A nurse is legally responsible for monitoring for side and adverse effects of medication D. Safeguarding of medications, such as controlled substances, is a legal responsibility of the nurse A nurse reviewing a client's health record notes a new prescription for lisinopril 10 mg PO once every day. The nurse should identify this as which of the following types of prescription? A.Single B.Stat C.Routine
D.Standing {{Correct Ans- C. A routine or standard prescription identifies medications to give on a regular schedule with or without a termination date or a specific number of doses. The nurse will administer this medication every day until the provider discontinues it. A nurse is reviewing a new prescription for ondansetron 4 mg PO PRN for nausea and vomiting for a client who has hyperemesis gravidarum. The nurse should clarify which of the following parts of the prescription with the provider? A.Name B.Dosage C.Route D.Frequency {{Correct Ans- D. This prescription does not include the time or frequency of medication administration. The nurse must clarify this with the prescribing provide A nurse is admitting a client and completing a preassessment before administering medications. Which of the following data should the nurse include in the preassessment? (Select all that apply.) A. Use of herbal teas B.Daily fluid intake C.Current health status D.Previous surgical history E.Food allergies {{Correct Ans- A. The nurse should inquire about the client's use of herbal products, which often contain caffeine, prior to medication administration because caffeine can affect medication biotransformation C. The nurse should review the client's current health status because new prescriptions can cause alterations in current health status
A nurse is preparing to administer haloperidol 2 mg PO every 12 hr. The amount available is haloperidol 1 mg/tablet. how many tablets should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero. {{Correct Ans- 2 tablets A nurse is preparing to administer amoxicillin 20 mg/kg/day PO to divide equally every 12 hr to a preschooler who weighs 44 lb. The amount available is amoxicillin suspension 250 mg/5 mL. how many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Do not use a trailing zero.) {{Correct Ans- 4 mL A nurse is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. how many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Do not use a trailing zero. {{Correct Ans- 0.8 mL A nurse is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen liquid 500 mg/5 mL. how many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero. {{Correct Ans- 6.5 mL A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero. {{Correct Ans- 125 mL/hr A nurse is assessing a client's IV infusion site. Which of the following findings should the nurse identify as an indication of phlebitis? (Select all that apply.) A.Pallor B.Dampness C.Erythema D.Coolness E.Pain {{Correct Ans- C. Erythema at the insertion site is a manifestation of phlebitis. E.Pain at the insertion site is a manifestation of phlebitis. A nurse manager is reviewing the facility's policies for IV therapy
with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism? A. Performing hand hygiene before and after IV insertion B.Rotating IV sites at least every 72 hr C.minimizing tourniquet time D.Avoiding reinserting the needle into an IV catheter {{Correct Ans- D. The nurse manager should remind the members of the team to avoid reinserting the stylet needle into an IV catheter. This action can result in severing the end of the catheter and consequently cause a catheter embolism A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take? A. Use a disposable razor to remove excess hair on the extremity. B.Select the back of the client's hand to insert the IV catheter. C.Distend the veins by using a blood pressure cuff. D.Direct the client to raise his arm above his heart {{Correct Ans- C.The nurse should distend the veins using a blood pressure cuff to reduce overfilling of the vein, which can result in a hematoma. A nurse assessing a client's IV catheter insertion site notes a hematoma. Which of the following actions should the nurse take? (Select all that apply.) A. Stop the infusion. B.Apply alcohol to the insertion site. C.Apply warm compresses to the insertion site
client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take? A.Administer the prescribed dose. B.Withhold the medication. C.Ask the provider to change the prescription to an oral form. D.Administer an oral antihistamine at the same time {{Correct Ans- B. The nurse should withhold the medication and notify the provider of the client's previous reaction to penicillin so that an alternative antibiotic can be prescribed. Allergic reactions to penicillin can range from mild to severe anaphylaxis, and prior sensitization should be reported to the provider. A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give? A."Be sure to limit your potassium intake while taking the medication." B."You should check your blood pressure every 8 hours while taking this medication." C."Your medication dosage will be increased if you develop tachycardia." D."Change positions slowly when you move from sitting to standing." {{Correct Ans- D. Orthostatic hypotension is a common adverse effect of antihypertensive medications. The client should move slowly to a sitting or standing position and should be taught to sit or lie down if lightheadedness or dizziness occurs A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client?
A.Cardiovascular B.Immune C.Central nervous D.Gastrointestina {{Correct Ans- C. The nurse should realize that extrapyramidal effects are movement disorders that can be caused by a number of central nervous system medications, such as typical antipsychotic medications A nurse is caring for a client who is taking oral oxycodone The client states he is also taking ibuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings? A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication B.A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication C.An increase in the expected therapeutic effect of both medications D.An increase in expected adverse effects for both medications {{Correct Ans- C. These medications work together to increase the pain-relieving effects of both medications. Oxycodone is a narcotic analgesic, and ibuprofen is an NSAID. They work by different mechanisms, but pain is better relieved when they are taken together A nurse is preparing to administer medications to a 4 - month-old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (Select all that apply.) A. Infants have a more rapid gastric emptying time. B.Infants have immature liver function. C.Infants' blood-brain barrier is poorly developed. D.Infants have an increased
D.Increased gastric motility {{Correct Ans- C. Older adults have reduced hepatic function, which can prolong the effects of medications the liver metabolizes. The client probably needs a lower dosage of the hypnotic medication A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority? A.Administer flumazenil. B.Identify the client's level of orientation. C.Infuse IV fluids. D.Prepare the client for gastric lavage {{Correct Ans- B. The first action the nurse should take when using the nursing process is to assess the client. Identifying the client's level of orientation is the priority action. A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching? A. "I should take the medication on an empty stomach." B."I will follow a low-sodium diet while taking this medication." C."I need to discontinue this medication slowly." D."I should not crush this medication before swallowing." {{Correct Ans- C. When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include? A. "Take this medication on an empty stomach"
B."Expect optimal therapeutic effects within 24 hr." C."Take this medication when needed for anxiety" D."This medication has a low risk for dependency." {{Correct Ans- D. Buspirone has a low risk for physical or psychological dependence or tolerance. A nurse is teaching a client who has obsessive-compulsive disorder and has a new prescription for paroxetine. Which of the following instructions should the nurse include? A. "It can take several weeks before you feel like the medication is helping." B."Take the medication just before bedtime to promote sleep." C."You should take the medication when needed for obsessive urges." D."monitor for weight gain while taking this medication." {{Correct Ans- A. Paroxetine can take 1 to 4 weeks before the client reaches full therapeutic benefit. A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorder and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage bruxism? (Select all that apply.) A. Concurrent administration of buspirone B.Administration of a different SSRI C.Use of a mouth guard D.Changing to a different class of antidepressant medication E.Increasing the dose of paroxetine {{Correct Ans- A. Concurrent administration of a low dose of buspirone
E. Chewing sugarless gum can minimize dry mouth, which is an adverse effect of amitriptyline A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for posttraumatic stress disorder. Which of the following statements should the nurse include in the teaching? A. "You may have a decreased desire for intimacy while taking this medication." B."You should take this medication at bedtime to help promote sleep." C."You will have fewer urinary adverse effects if you urinate just before taking this medication." D."You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication. {{Correct Ans- A.Decreased libido is a potential adverse effect of fluoxetine and other SSRIs A nurse is caring for a client who has depression and a new prescription for venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply) A.Cough B.Dizziness C.Decreased libido D.Alopecia E.hypotension {{Correct Ans- A.Cough and dyspnea can indicate that the client has developed bronchitis, which is an adverse effect of venlafaxine. B.Dizziness is a common adverse effect of venlafaxine. C.Sexual dysfunction, such as decreased
A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome? A.Bruising B.Fever C.Abdominal pain D.Rash {{Correct Ans- B.Fever is a manifestation of serotonin syndrome, which can result from taking an SSRI such as sertraline A nurse is reviewing laboratory findings and notes that a client's plasma lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse? A.Perform immediate gastric lavage. B.Prepare the client for hemodialysis. C.Administer an additional oral dose of lithium. D.Request a stat repeat of the laboratory test {{Correct Ans- A.Gastric lavage is appropriate for a client who has severe toxicity, as evidenced by a plasma lithium level of 2.1 mEq/L. This action will lower the client's lithium level. A nurse is caring for a client who has a new prescription for lithium carbonate. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following? A. Avoid the use of acetaminophen for headaches. B.Restrict intake of foods rich in sodium. C.Decrease fluid intake to less than 1,500 mL daily
A. "This medication can safely be taken during pregnancy." B."Eliminate grapefruit juice from your diet." C."You will need to have a complete blood count and carbamazepine levels drawn periodically." D."Notify your pr ovider if you develop a rash." E."Avoid driving for the first few days after starting this medication. {{Correct Ans- B. Grapefruit juice affects carbamazepine metabolism and should be avoided. C. Carbamazepine blood levels and the CBC should be monitored during therapy. The client is at risk for bone marrow depression while taking carbamazepine and should notify the provider for a sore throat or other manifestations of an infection. D. Carbamazepine can cause Stevens-Johnson syndrome, which can be fatal. The client should notify the provider promptly if a rash occurs. E. CNS effects such as drowsiness or dizziness can occur early in treatment with carbamazepine and the client should avoid activities requiring alertness until these effects subside A nurse is teaching a client who has schizophrenia strategies to cope with anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects? A. Take the medication in the morning to prevent insomnia. B.Chew sugarless gum to moisten the mouth. C.Use cooling measures
to decrease fever. D.Take an antacid to relieve nausea {{Correct Ans- B.Chewing sugarless gum can help the client cope with dry mouth, a potential anticholinergic effect of fluphenazine A nurse is assessing a male client who recently began taking haloperidol. Which of the following findings is the highest priority to report to the provider? A. Shuffling gait B.Neck spasms C.Drowsiness D.Impotence {{Correct Ans- B. Neck spasms are an indication of acute dystonia which is a crisis situation requiring rapid treatment. This is the greatest risk to the client and is therefore the priority finding. A nurse is providing discharge teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching? A."You should have a high-carbohydrate snack between meals and at bedtime." B."You are likely to develop hand tremors if you take this medication for a long period of time." C."You may experience temporary numbness of your mouth after each dose." D."You should have your white blood cell count monitored every week. {{Correct Ans- D. Due to the risk for fatal agranulocytosis weekly monitoring of the client's WBC count is recommended while taking clozapine A nurse is providing teaching for a male client who has schizophrenia
