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RN Pharmacology LATEST 2025 ACTUAL EXAM
242 QUESTIONS AND ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
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 ANSWERS 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 ANSWERS Answer:
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.have the client lie on her side.
B.Ask the client to look
up at the ceiling.
C.Tell the client to blink when the drops enter her eye.
D.Drop the medication
into the center of the
client's conjunctival sac.
E.Instruct the client to close her eye gently after instillation - CORRECT ANSWERS B. The client should look upward to
keep the drops from falling onto her cornea.
D. The nurse should drop the medication into the
center of the conjunctival sac to promote distribution.
E. The client should close her eye gently
to promote distribution of the medication
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 ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS D. This prescription does not include the time or frequency of medication administration. The nurse must clarify this with the prescribing provide
B."Another nurse should
listen to the phone call."
C."The provider can clarify
the prescription when he
signs the health record."
D."I should omit the 'r
ead back' if this is a one-time prescription - CORRECT ANSWERS B.A second nurse should listen to a telephone
prescription to prevent errors in communication.
A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g
in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should
adjust the manual IV infusion to deliver how many gtt/min? (Round
the answer to the nearest whole number. Do not use a trailing zero. - CORRECT ANSWERS 22 gtt/min
A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride
(0.9% NaCl) to infuse over 30 min. 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 ANSWERS 200 mL/hr
A nurse is preparing to administer furosemide 80 mg PO daily. The amount available is furosemide oral
solution 10 mg/1 mL. how many mL should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.) - CORRECT ANSWERS 8 mL
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 ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS 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
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 ANSWERS 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
D.Elevate the client's arm.
E.Obtain a specimen for
culture at the insertion site - CORRECT ANSWERS C. Warm compresses can help promote healing of a hematoma.
D. Elevation of the arm helps reduce edema, which can cause pressure and pain and additional bleeding in the area of the hematoma.
A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a
potential contraindication to a medication for which of the following clients? (Select all that apply.)
A.A client at 8 weeks of
gestation who asks for an
influenza immunization
B.A client who takes
prednisone and has a
possible fungal infection
C.A client who has chronic
liver disease and is
taking hydrocodone
D.A client who has peptic ulcer disease, takes sucralfate, and tells the nurse she has started taking OTC aluminum hydroxide
E.A client who has a pr
osthetic heart valve, takes warfarin, and reports a suspected pregnancy - CORRECT ANSWERS B. Glucocorticoids should not be taken by a client
who has a possible systemic fungal infection. The nurse should
recognize a contraindication and notify the provider.
C. Acetaminophen is contraindicated due to toxicity for a client who has a liver disorder. The nurse should notify the provider,
who can prescribe a medication that does not contain acetaminophen.
E. Warfarin is a Pregnancy Category X medication,
which can cause severe birth defects to the fetus. The nurse
should notify the provider about the suspected pregnancy
A nurse is preparing to administer an Im dose of penicillin to a client who has a new prescription. The
client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take?
when you move from
sitting to standing." - CORRECT ANSWERS 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 ANSWERS 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 ANSWERS 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
ability to absorb topical
medications.
E.Infants have an
increased number of
protein-binding sites. - CORRECT ANSWERS B. Infants have immature liver function until
1 year of age. The nurse should administer medications
the liver metabolizes in smaller dosages.
C. Infants have a poorly developed blood-brain
B.First-pass effect
C.Reduced hepatic function
D.Increased gastric motility - CORRECT ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS 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
D. Changing to different class of antidepressant medication
that does not have the adverse effect of bruxism is an effective measure
A nurse is caring for a client who has a new prescription for phenelzine
for the treatment of depression. Which of the following indicates that the client has developed an
adverse effect of this medication?
A.Orthostatic hypotension
B. hearing loss
C.Gastrointestinal bleeding
D.Weight loss - CORRECT ANSWERS A.Orthostatic hypotension is an adverse of effect of mAOIs, including phenelzine.
A nurse is providing teaching to a client who has a new prescription
for amitriptyline for treatment of depression. Which of the following
should the nurse include in the teaching? (Select all that apply.)
A.Expect therapeutic
effects in 24 to 48 hr.
B.Discontinue the
medication after a week
of improved mood.
C.Change positions slowly
to minimize dizziness.
D.Decrease dietary fiber
intake to control diarrhea.
E.Chew sugarless gum to
prevent dry mouth - CORRECT ANSWERS C. Changing positions slowly helps prevent orthostatic
hypotension, which is an adverse effect of amitriptyline
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 ANSWERS 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
