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RN Pharmacology Online Practice 2019 B
Questions With Complete Solutions
A nurse contacts a client's provider on the telephone to obtain a prescription for pain medication. Which of the following actions should the nurse take? a. write the order on a prescription pad designed for the client's provider b. have the provider spell out the unfamiliar medication names c. read the prescription back to the provider using abbreviations d. consult with a second nurse for any questions regarding dosage correct answer: b. have the provider spell out the unfamiliar medication names The nurse should ask the provider to spell out the name of the medication if the stated name is one the nurse is not familiar with. A nurse in a clinic is caring for a client who is taking aspirin for the treatment of arthritis. The nurse should identify which of the following findings as an indication that the client is beginning to exhibit salicylism? a. gastric distress b. oliguria c. excessive bruising d. tinnitus correct answer: d. tinnitus
Tinnitus is a manifestation of aspirin toxicity, also called salicylism. Other manifestations include sweating, headache, and dizziness. A circulating nurse is planning care for a client who is scheduled for surgery has a latex allergy. Which of the following actions should the nurse include in the plan of care? a. schedule the client for the last surgery of the day b. place monitoring cords and tubes in a stockinet c. choose rubber injection ports for fluid administration d. ensure phenytoin IV is readily available correct answer: b. place monitoring cords and tubes in a stockinet The nurse should place monitoring devices in a stockinet to prevent direct contact with the client's skin. A nurse is assessing a client who is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor? a. paresthesia b. increased blood pressure c. fever d. respiratory depression correct answer: b. increased blood pressure The therapeutic effect of epoetin alfa is an increase in hematocrit levels, which can result in an increase in a client's blood pressure. If the client's hematocrit level rises too rapidly, hypertension and seizures can result. The nurse should monitor the client's blood pressure and ensure hypertension is controlled prior to administering the medication.
a. cholelithiasis b. asthma c. angina pectoris d. tachycardia correct answer: b. asthma Asthma is a contraindication for receiving propranolol. Propranolol is an adrenergic antagonist which blocks the beta receptors in the lungs, causing bronchoconstriction and leading to serious airway resistance and possibly respiratory arrest. A nurse is caring for a client who has pneumonia. The client tells the nurse she is pregnant and that she has not told her provider yet. The nurse should identify that pregnancy is a contraindication for receiving which of the following medications? a. acetaminophen b. ipratropium c. benzonatate d. doxycycline correct answer: d. doxycycline Doxycycline is a tetracycline antibiotic. The nurse should identify that doxycycline can cause teratogenic effects such as staining of the infant's teeth when exposed to this medication. Therefore, this medication is contraindicated for the client. A nurse is teaching about self-administration of transdermal medication with a male client who has a new prescription for nitroglycerin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? a. "I can apply the patch to a chest area that has hair."
b. "I can take this medication while using an erectile dysfunction product." c. "I will remove the patch after 14 hours." d. "I need to apply a new patch to the same area every day." correct answer: c. "I will remove the patch after 14 hours." The client should remove the patch after 12 to 14 hr to prevent tolerance of the medication. A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first? a. administer epinephrine 0.5 mL via IV bolus b. discontinue the medication IV infusion c. elevate the client's legs above the level of the heart d. collect a blood specimen for ABGs correct answer: b. discontinue the medication IV infusion The greatest risk to the client is respiratory arrest from anaphylaxis. Therefore, the first action the nurse should take is to discontinue the medication IV infusion to prevent the client from receiving more medication. However, the nurse should not remove the IV catheter. Instead, the nurse should change the tubing and administer 0.9% sodium chloride by continuous IV infusion. A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the following client findings as an indication that she should complete an incident report? a. the client reports shortness of breath
Which of the following medications should the nurse plan to instruct the client to use prior to physical activity? a. cromolyn b. beclomethasone c. budesonide d. tiotropium correct answer: a. cromolyn Cromolyn sodium stabilizes mast cells, which inhibit the release of histamine and other inflammatory mediators. The client should use cromolyn 10 to 15 min before planning to exercise to prevent bronchospasms. A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor? a. creatinine kinase b. erythrocyte sedimentation rate c. international normalized ratio d. potassium correct answer: a. creatinine kinase The client who is taking atorvastatin can develop an adverse effect called rhabdomyolysis, which causes muscle weakness or pain and can progress to myositis. Creatinine kinase levels rise in response to enzymes released with muscle injury. A nurse is preparing to mix and administer dantrolene via IV bolus to a client who has developed malignant hyperthermia during surgery. Which of the following actions should the nurse take? a. administer the reconstituted medication slowly over 5 min b. store the reconstituted medication in the refrigerator
c. use the reconstituted medication within 12 hours d. reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent correct answer: d. reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent The nurse should dilute the medication with 60 mL of sterile water without a bacteriostatic agent and inject rapidly. A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider? a. dry cough b. pedal edema c. bruising d. yellow-tinged vision correct answer: d. yellow-tinged vision The nurse should instruct the client to monitor for and report yellow-tinged vision, which is a sign of digoxin toxicity. Other manifestations of digoxin toxicity include nausea, vomiting, loss of appetite, and fatigue. As the digoxin levels increase, the client can experience cardiac dysrhythmias. A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider? a. chest pressure b. white patches on the tongue c. bruising
Zolpidem is used for short-term treatment of insomnia. Therefore, the provider should reassess the client before refilling the prescription. A nurse is providing teaching to a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the medication with which of the following to promote absorption? a. vitamin E b. orange juice c. milk d. antacids correct answer: b. orange juice The absorption of ferrous sulfate is enhanced by a vitamin C source, such as orange juice. A nurse is teaching about a new prescription for ciprofloxacin to a client who has a urinary tract infection. The nurse should identify which of the following statements as an indication that the client understands the teaching? a. "I will take this medication with an antacid to prevent gastrointestinal upset." b. "I will stop taking this medication when I no longer have pain upon urination." c. "I will report any signs of tendon pain or swelling." d. "I will take this medication with milk." correct answer: c. "I will report any signs of tendon pain or swelling." Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture. This risk is increased in older adult clients, so
the client should notify the provider at the onset of tendon pain or swelling. A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching? a. take the medication with food b. expect a fine, red rash as a transient effect c. drink 8 to 10 glasses of water daily d. store the medication in the refrigerator correct answer: c. drink 8 to 10 glasses of water daily The nurse should instruct the client to increase water intake to 1,920 to 2,400 mL (65 to 81 oz) a day to decrease the chance of kidney damage from crystallization. A nurse is caring for a client who is receiving end-of-life care and has a prescription for fentanyl patches. Which of the following information regarding the adverse effects of fentanyl should the nurse plan to give to the client and family? a. the provider will prescribe naloxone at home for respiratory depression b. remove the patch to reverse the adverse effects immediately c. expect an increase in urinary output d. take a stool softened on a daily basis correct answer: d. take a stool softener on a daily basis Constipation is an adverse effect of opioid use. Stool softeners can decrease the severity of this adverse effect.
A nurse is assessing a client who is taking amitriptyline for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? a. tinnitus b. urinary frequency c. dry mouth d. exophthalmos correct answer: c. dry mouth The nurse should expect the client to have a dry mouth due to the blocking of acetylcholine receptors that cause anticholinergic responses. A nurse is teaching a client who has a new prescription for docusate sodium about the medication's mechanism of action. Which of the following information should the nurse include in the teaching? a. docusate sodium reduces the surface tension of the stools to change their consistency b. docusate sodium causes rectal contractions c. docusate sodium acts as a fiber agent, increasing bulk in the intestines d. docusate sodium stimulates the motility of the intestines correct answer: a. docusate sodium reduces the surface tension of the stools to change their consistency Docusate sodium is a surfactant that softens stool by reducing surface tension, allowing water to penetrate more easily into the stool.
A nurse is administering diazepam to a client who is having a colonoscopy. Which of the following actions should the nurse take? a. ensure flumazenil is available to administer for toxicity management b. monitor the client for an increase in blood pressure c. expect the client to become unconscious within 30 seconds d. measure the capnography level every hour until the client is awake and oriented correct answer: a. ensure flumazenil is available to administer for toxicity management The nurse should monitor the client for manifestations of diazepam toxicity, such as respiratory depression and hypotension. The nurse should be prepared to administer flumazenil to reverse the effects of diazepam. A nurse is caring for a client who has a magnesium level of 3. mEq/L. The nurse should expect to administer which of the following medications? a. magnesium gluconate b. cinacalcet c. calcium gluconate d. regular insulin correct answer: c. calcium gluconate The nurse should expect to administer IV calcium gluconate to the client and prepare to provide ventilatory support. This client is at risk for respiratory depression and cardiac dysrhythmias because a magnesium level of 3.1 mEq/L is above the expected reference range of 1.3 to 2.1 mEq/L.
weight or develops shortness of breath, they should notify the provide -The client should not drink grapefruit juice while taking diltiazem because it can interfere with metabolism of the medication by increasing the blood levels of diltiazem and leading to toxicity. -Diltiazem is a calcium channel blocker that causes vascular dilation, which can result in orthostatic hypotension. The client should rise slowly when standing and avoid hazardous activities until there is a stabilization of the medication and dizziness no longer occurs. A nurse is caring for a client who has developed hypomagnesemia due to long-term therapy with lansoprazole. The nurse should monitor the client for which of the following manifestations? a. bradycardia b. hypotension c. muscle weakness d. disorientation correct answer: d. disorientation The nurse should monitor the client for disorientation and confusion as manifestations of hypomagnesemia. The nurse should also assess the client for a positive Chvostek's and Trousseau's signs. A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first? a. perform a capillary blood glucose test
b. provide the client with a protein-rich snack c. give the client 120 mL (4 oz) of orange juice d. schedule an early meal tray correct answer: a. perform a capillary blood glucose test The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and seizures. A nurse is teaching a client who is taking allopurinol for the treatment of gout. Which of the following information should the nurse include in the teaching? a. plan to increase the dosage each week by 200 mg increments b. prolonged use of the medication can cause glaucoma c. drink 2 L of water daily d. a fine red rash is transient and can be treated with antihistamines correct answer: c. drink 2 L of water daily The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury, because allopurinol is eliminated through the kidneys. A nurse is caring for a client who has hypocalcemia and is receiving calcium citrate. The nurse should identify that which of the following findings indicates a therapeutic response to the medication? a. positive Chvostek's sign b. client report of decreased paresthesia c. client report if increased thirst
b. "I will leave the patch on for 4 hours after applying the new patch." c. "I will fold the sticky sides of the old patch together before disposing it." d. "I will apply the patch within 14 days of menses." correct answer: c. "I will fold the sticky sides of the old patch together before disposing it." The client should fold the sticky sides of the old patch together and then place it in a childproof container to ensure safe disposal of the patch. A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicates that the medication is effective? a. decreased blood pressure d. increased heart rate c. increased cardiac output d. decreased serum potassium correct answer: c. increased cardiac output Dopamine is an adrenergic that causes a receptor specificity effect, which increases cardiac output and improves perfusion. A nurse is caring for a client who is recovering from deep-vein thrombosis and is to start taking warfarin. For which of the following findings should the nurse monitor as an adverse effect of warfarin? a. hypertension b. low INR c. constipation
d. bleeding gums correct answer: d. bleeding gums The nurse should monitor the client for bleeding gums, which is an adverse effect of warfarin, an anticoagulant. A nurse is administered digoxin immune Fab to a client who received the incorrect dose of digoxin over a period of 3 days. The nurse should identify that which of the following findings indicates the antidote was effective? a. normal sinus rhythm b. digoxin level of 2.5 ng/mL c. decrease in blood pressure d. potassium level of 3.2 mEq/L correct answer: a. normal sinus rhythm Dysrhythmias are a life-threatening adverse effect of digoxin toxicity. The return of the heart to normal sinus rhythm indicates a therapeutic response to the antidote. Digoxin immune Fab is administered to a client who is experiencing severe digoxin toxicity. It binds with digoxin and works to reduce the client's blood digoxin level. A nurse is providing teaching to a client who has depression and a new prescription for fluoxetine. Which of the following statements by the client indicates an understanding of the teaching? a. "I should start to feel better within 24 hours of starting this medication." b. "I will be sure to follow a strict diet to avoid foods with tyramine."
