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Medication Side Effects and Adverse Reactions, Exams of Nursing

Chamberlain College of NursingNursing

Various medication side effects and adverse reactions that nurses should be aware of when caring for patients. It covers a range of medications, including those used to treat parkinson's disease, epilepsy, alcohol addiction, and heart disease. Information on the specific side effects and adverse reactions associated with each medication, as well as the appropriate nursing interventions and monitoring required. Key topics include cholinergic crisis, hematological changes, liver function, and the importance of monitoring vital signs and laboratory values. The document aims to equip nurses with the knowledge and skills to effectively manage medication-related issues and ensure the safety and well-being of their patients.

Typology: Exams

2024/2025

Available from 10/01/2024

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PHARMACOLOGY NCLEX EXAM QUIZLET
2025 LATEST UPDATE WITH COMPLETE
QUESTIONS AND CORRECT ANSWERS
WITH DETAILED RATIONALES
Oxybutynin chloride (Ditropan XL) is prescribed for a client with
neurogenic bladder. Which sign would indicate a possible toxic
effect related to this medication?
1. Pallor
2. Drowsiness
3. Bradycardia
4. Restlessness Correct Answer 4. Restlessness
Rationale:
Toxicity (overdosage) of this medication produces central nervous
system excitation, such as nervousness, restlessness,
hallucinations, and irritability. Other signs of toxicity include
hypotension or hypertension, confusion, tachycardia, flushed or
red face, and signs of respiratory depression. Drowsiness is a
frequent side effect of the medication but does not indicate
overdosage.
A client with myasthenia gravis is suspected of having cholinergic
crisis. Which of the following indicate that this crisis exists?
1. Ataxia
2. Mouth sores
3. Hypotension
4. Hypertension Correct Answer 4. Hypertension
Rationale:
Cholinergic crisis occurs as a result of an overdose of medication.
Indications of cholinergic crisis include gastrointestinal
disturbances, nausea, vomiting, diarrhea, abdominal cramps,
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Download Medication Side Effects and Adverse Reactions and more Exams Nursing in PDF only on Docsity!

PHARMACOLOGY NCLEX EXAM QUIZLET

2025 LATEST UPDATE WITH COMPLETE

QUESTIONS AND CORRECT ANSWERS

WITH DETAILED RATIONALES

Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?

  1. Pallor
  2. Drowsiness
  3. Bradycardia
  4. Restlessness Correct Answer 4. Restlessness Rationale: Toxicity (overdosage) of this medication produces central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity include hypotension or hypertension, confusion, tachycardia, flushed or red face, and signs of respiratory depression. Drowsiness is a frequent side effect of the medication but does not indicate overdosage. A client with myasthenia gravis is suspected of having cholinergic crisis. Which of the following indicate that this crisis exists?
  5. Ataxia
  6. Mouth sores
  7. Hypotension
  8. Hypertension Correct Answer 4. Hypertension Rationale: Cholinergic crisis occurs as a result of an overdose of medication. Indications of cholinergic crisis include gastrointestinal disturbances, nausea, vomiting, diarrhea, abdominal cramps,

increased salivation and tearing, miosis, hypertension, sweating, and increased bronchial secretions. A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs?

  1. Vitamin K
  2. Atropine sulfate
  3. Protamine sulfate
  4. Acetylcysteine (Mucomyst) Correct Answer 2. Atropine sulfate Rationale: The antidote for cholinergic crisis is atropine sulfate. Vitamin K is the antidote for warfarin (Coumadin). Protamine sulfate is the antidote for heparin, and acetylcysteine (Mucomyst) is the antidote for acetaminophen (Tylenol). Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client is experiencing an adverse reaction?
  5. Pruritus
  6. Tachycardia
  7. Hypertension
  8. Impaired voluntary movements Correct Answer 4. Impaired voluntary movements Rationale: Dyskinesia and impaired voluntary movement may occur with high levodopa dosages. Nausea, anorexia, dizziness, orthostatic hypotension, bradycardia, and akinesia (the temporary muscle weakness that lasts 1 minute to 1 hour, also known as the "on-off phenomenon") are frequent side effects of the medication.

** A helpful hint may be to remember that the theophylline therapeutic range and the acetaminophen (Tylenol) therapeutic range are the same as the phenytoin (Dilantin) therapeutic range.** Ibuprofen (Advil) is prescribed for a client. The nurse tells the client to take the medication:

  1. With 8 oz of milk
  2. In the morning after arising
  3. 60 minutes before breakfast
  4. At bedtime on an empty stomach Correct Answer 1. With 8 oz of milk Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs should be given with milk or food to prevent gastrointestinal irritation. Options 2, 3, and 4 are incorrect. A nurse is caring for a client who is taking phenytoin (Dilantin) for control of seizures. During data collection, the nurse notes that the client is taking birth control pills. Which of the following information should the nurse provide to the client?
  5. Pregnancy should be avoided while taking phenytoin (Dilantin).
  6. The client may stop taking the phenytoin (Dilantin) if it is causing severe gastrointestinal effects.
  7. The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin).
  8. The increased risk of thrombophlebitis exists while taking phenytoin (Dilantin) and birth control pills together. Correct Answer 3. The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin). Rationale: Phenytoin (Dilantin) enhances the rate of estrogen metabolism, which can decrease the effectiveness of some birth control pills. Options 1, 2, are 4 are not accurate.

A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol). Which laboratory result would indicate that the client is experiencing an adverse reaction to the medication?

  1. Sodium level, 140 mEq/L
  2. Uric acid level, 5.0 mg/dL
  3. White blood cell count, 3000 cells/mm
  4. Blood urea nitrogen (BUN) level, 15 mg/dL Correct Answer 3. White blood cell count, 3000 cells/mm Rationale: Adverse effects of carbamazepine (Tegretol) appear as blood dyscrasias, including aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, cardiovascular disturbances, thrombophlebitis, dysrhythmias, and dermatological effects. Options 1, 2, and 4 identify normal laboratory values. A client is receiving meperidine hydrochloride (Demerol) for pain. Which of the following are side effects of this medication. Select all that apply.
  5. Diarrhea
  6. Tremors
  7. Drowsiness
  8. Hypotension
  9. Urinary frequency
  10. Increased respiratory rate Correct Answer 2. Tremors
  11. Drowsiness
  12. Hypotension Rationale: Meperidine hydrochloride is an opioid analgesic. Side effects include respiratory depression, drowsiness, hypotension, constipation, urinary retention, nausea, vomiting, and tremors. Dantrolene sodium (Dantrium) is prescribed for a client experiencing flexor spasms, and the client asks the nurse about

Cyclobenzaprine (Flexeril) is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which of the following disorders, if noted in the client's record, would indicate a need to contact the health care provider regarding the administration of this medication?

  1. Glaucoma

  2. Emphysema

  3. Hyperthyroidism

  4. Diabetes mellitus Correct Answer 1. Glaucoma Rationale: Because this medication has anticholinergic effects, it should be used with caution in clients with a history of urinary retention, angle-closure glaucoma, and increased intraocular pressure. Cyclobenzaprine hydrochloride should be used only for short-term 2 - to 3-week therapy. Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic. The nurse is collecting data on the client and is providing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication?

  5. A history of hyperthyroidism

  6. A history of diabetes insipidus

  7. When the last full meal was consumed

  8. When the last alcoholic drink was consumed Correct Answer

  9. When the last alcoholic drink was consumed Rationale: Disulfiram is used as an adjunct treatment for selected clients with chronic alcoholism who want to remain in a state of enforced sobriety. Clients must abstain from alcohol intake for at least 12 hours before the initial dose of the medication is administered. The most important data are to determine when the last alcoholic drink was consumed. The medication is used with caution in clients with diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic disease. It is also contraindicated

in severe heart disease, psychosis, or hypersensitivity related to the medication. A nurse is collecting data from a client and the client's spouse reports that the client is taking donepezil hydrochloride (Aricept). Which disorder would the nurse suspect that this client may have based on the use of this medication?

  1. Dementia
  2. Schizophrenia
  3. Seizure disorder
  4. Obsessive-compulsive disorder Correct Answer 1. Dementia Rationale: Donepezil hydrochloride is a cholinergic agent used in the treatment of mild to moderate dementia of the Alzheimer type. It enhances cholinergic functions by increasing the concentration of acetylcholine. It slows the progression of Alzheimer's disease. Options 2, 3, and 4 are incorrect. Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding about administration of the medication?
  5. "I should take the medication with my evening meal."
  6. "I should take the medication at noon with an antacid."
  7. "I should take the medication in the morning when I first arise."
  8. "I should take the medication right before bedtime with a snack." Correct Answer 3. "I should take the medication in the morning when I first arise." Rationale: Fluoxetine hydrochloride is administered in the early morning without consideration to meals. Eliminate options 1, 2, and 4 because they are comparable or alike and indicate taking the medication with an antacid or food.
  1. No rapid heartbeats or anxiety
  2. No paranoid thought processes
  3. No thought broadcasting or delusions
  4. No reports of alcohol withdrawal symptoms Correct Answer 1. No rapid heartbeats or anxiety Rationale: Buspirone hydrochloride is not recommended for the treatment of drug or alcohol withdrawal, paranoid thought disorders, or schizophrenia (thought broadcasting or delusions). Buspirone hydrochloride is most often indicated for the treatment of anxiety and aggression. A client arrives at the health care clinic and tells the nurse that he has been doubling his daily dosage of bupropion hydrochloride (Wellbutrin) to help him get better faster. The nurse understands that the client is now at risk for which of the following?
  5. Insomnia
  6. Weight gain
  7. Seizure activity
  8. Orthostatic hypotension Correct Answer 3. Seizure activity Rationale: Bupropion does not cause significant orthostatic blood pressure changes. Seizure activity is common in dosages greater than 450 mg daily. Bupropion frequently causes a drop in body weight. Insomnia is a side effect, but seizure activity causes a greater client risk. A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse instructs the client to avoid consuming which foods while taking this medication? Select all that apply.
  9. Figs
  10. Yogurt
  11. Crackers
  12. Aged cheese

5 Tossed salad

  1. Oatmeal cookies Correct Answer 1. Figs
  2. Yogurt
  3. Aged cheese Rationale: Phenelzine sulfate (Nardil) is a monoamine oxidase inhibitor(MAOI). The client should avoid taking in foods that are high in tyramine. Use of these foods could trigger a potentially fatal hypertensive crisis. Some foods to avoid include yogurt, aged cheeses, smoked or processed meats, red wines, and fruits such as avocados, raisins, and figs. A client with diabetes mellitus who has been controlled with daily insulin has been placed on atenolol (Tenormin) for the control of angina pectoris. Because of the effects of atenolol, the nurse determines that which of the following is the most reliable indicator of hypoglycemia?
  4. Sweating
  5. Tachycardia
  6. Nervousness
  7. Low blood glucose level Correct Answer 4. Low blood glucose level Rationale: β-Adrenergic blocking agents, such as atenolol, inhibit the appearance of signs and symptoms of acute hypoglycemia, which would include nervousness, increased heart rate, and sweating. Therefore, the client receiving this medication should adhere to the therapeutic regimen and monitor blood glucose levels carefully. Option 4 is the most reliable indicator of hypoglycemia. A nurse is preparing to administer digoxin (Lanoxin), 0.125 mg orally, to a client with heart failure. Which vital sign is most important for the nurse to check before administering the medication?
  8. Heart rate

Which of the following statements indicates that the client understands the instructions?

  1. "I will never be able to drive a car."
  2. "My anticonvulsant medication will clear up my skin."
  3. "I can't drink alcohol while I am taking my medication."
  4. "If I forget my morning medication, I can take two pills at bedtime." Correct Answer 3. "I can't drink alcohol while I am taking my medication." Rationale: Alcohol will lower the seizure threshold and should be avoided. Adolescents can obtain a driver's license in most states when they have been seizure free for 1 year. Anticonvulsants cause acne and oily skin; therefore a dermatologist may need to be consulted. If an anticonvulsant medication is missed, the health care provider should be notified. A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include a β-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?
  5. Dyspnea, edema, and palpitations
  6. Chest pain, hypotension, and paresthesia
  7. Double vision, loss of appetite, and nausea
  8. Constipation, dry mouth, and sleep disorder Correct Answer
  9. Double vision, loss of appetite, and nausea Rationale: Double vision, loss of appetite, and nausea are signs of digoxin toxicity. Additional signs of digoxin toxicity include bradycardia, difficulty reading, visual alterations such as green and yellow vision or seeing spots or halos, confusion, vomiting, diarrhea, decreased libido, and impotence. gastrointestinal (GI) and visual disturbances occur with digoxin toxicity

A client is being treated for acute congestive heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24 breaths/min. After the initial dose, which of the following is the priority assessment?

  1. Monitoring weight loss
  2. Monitoring temperature
  3. Monitoring blood pressure
  4. Monitoring potassium level Correct Answer 3. Monitoring blood pressure Rationale: Bumetanide is a loop diuretic. Hypotension is a common side effect associated with the use of this medication. The other options also require assessment but are not the priority. priority ABCs—airway, breathing, and circulation Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?
  5. Protamine sulfate
  6. Potassium chloride
  7. Phytonadione (vitamin K )
  8. Aminocaproic acid (Amicar) Correct Answer 1. Protamine sulfate Rationale: The antidote to heparin is protamine sulfate; it should be readily available for use if excessive bleeding or hemorrhage occurs. Potassium chloride is administered for a potassium deficit. Vitamin K is an antidote for warfarin sodium. Aminocaproic acid is the antidote for thrombolytic therapy. Meperidine hydrochloride (Demerol) is prescribed for the client with pain. Which of the following would the nurse monitor for as a side effect of this medication?
  1. "I need to call my doctor if I experience nasal congestion from this medication." Correct Answer 3. "If my vision becomes blurred, I don't need to be concerned about it." Rationale: The client needs to be told that the urine may turn brown, black, or green. Other adverse effects include blurred vision, nasal congestion, urticaria, and rash. The client needs to be instructed that, if these adverse effects occur, the health care provider needs to be notified. The medication is used to relieve muscle spasms. Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which of the following as a priority action before administering the medication?
  2. Listen to the client's lung sounds.
  3. Check the client's blood pressure.
  4. Check the recent electrolyte levels.
  5. Assess the client for muscle weakness. Correct Answer 2. Check the client's blood pressure. Rationale: Atenolol hydrochloride is a beta-blocker used to treat hypertension. Therefore the priority nursing action before administration of the medication is to check the client's blood pressure. The nurse also checks the client's apical heart rate. If the systolic blood pressure is below 90 mm Hg or the apical pulse is 60 beats per minute or lower, the medication is withheld and the registered nurse and/or health care provider is notified. The nurse would check baseline renal and liver function tests. The medication may cause weakness, and the nurse would assist the client with activities if weakness occurs. Beta-blockers have "-lol" at the end of the medication name A nurse is preparing to administer furosemide (Lasix) to a client with a diagnosis of heart failure. The most important laboratory

test result for the nurse to check before administering this medication is:

  1. Potassium level
  2. Creatinine level
  3. Cholesterol level
  4. Blood urea nitrogen Correct Answer 1. Potassium level Rationale: Furosemide is a loop diuretic. The medication causes a decrease in the client's electrolytes, especially potassium, sodium, and chloride. Administering furosemide to a client with low electrolyte levels could precipitate ventricular dysrhythmias. Options 2 and 4 reflect renal function. The cholesterol level is unrelated to the administration of this medication. A nurse provides dietary instructions to a client who will be taking warfarin sodium (Coumadin). The nurse tells the client to avoid which food item?
  5. Grapes
  6. Spinach
  7. Watermelon
  8. Cottage cheese Correct Answer 2. Spinach Rationale: Warfarin sodium is an anticoagulant. Anticoagulant medications act by antagonizing the action of vitamin K, which is needed for clotting. When a client is taking an anticoagulant, foods high in vitamin K often are omitted from the diet. Vitamin K-rich foods include green, leafy vegetables, fish, liver, coffee, and tea. A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which of the following vital signs is most important for the nurse to check before administering the medication?

Rationale: Metoprolol (Lopressor) is classified as a beta-adrenergic blocker and is used in the treatment of hypertension, angina, and myocardial infarction. Baseline nursing assessments include measurement of BP and AP immediately before administration. If the systolic BP is below 90 mm/Hg and the AP is below 60 beats/min, the nurse should withhold the medication and document this action. Although the registered nurse should be informed of the client's vital signs, it is not necessary to do so immediately. The medication should not be administered because the data is outside of the prescribed parameters for this medication. The nurse should not administer half of the medication, or alter any dosages at any point in time. A nurse is preparing to administer eardrops to an infant. The nurse plans to:

  1. Pull up and back on the ear and direct the solution onto the eardrum.
  2. Pull down and back on the ear and direct the solution onto the eardrum.
  3. Pull down and back on the ear and direct the solution toward the wall of the canal.
  4. Pull up and back on the ear lobe and direct the solution toward the wall of the canal. Correct Answer 3. Pull down and back on the ear and direct the solution toward the wall of the canal. Rationale: When administering eardrops to an infant, the nurse pulls the ear down and straight back. In the adult or a child older than 3 years, the ear is pulled up and back to straighten the auditory canal. The medication is administered by aiming it at the wall of the canal rather than directly onto the eardrum. A nurse is assisting in preparing to administer acetylcysteine (Mucomyst) to a client with an overdose of acetaminophen (Tylenol). The nurse prepares to administer the medication by:
  1. Administering the medication subcutaneously in the deltoid muscle
  2. Administering the medication by the intramuscular route in the gluteal muscle
  3. Administering the medication by the intramuscular route, mixed in 10 mL of normal saline
  4. Mixing the medication in a flavored ice drink and allowing the client to drink the medication through a straw Correct Answer 4. Mixing the medication in a flavored ice drink and allowing the client to drink the medication through a straw Rationale: Because acetylcysteine has a pervasive odor of rotten eggs, it must be disguised in a flavored ice drink. It is consumed preferably through a straw to minimize contact with the mouth. It is not administered by the intramuscular or subcutaneous route. Knowing that the medication is a solution that is also used for nebulization treatments will assist you to select the option that indicates an oral route A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting skeletal muscle relaxant. Which of the following would indicate that the client is experiencing a side effect related to this medication?
  5. Headache
  6. Drowsiness
  7. Urinary retention
  8. Increased salivation Correct Answer 2. Drowsiness Rationale: Incoordination and drowsiness are common side effects resulting from this medication. Options 1, 3, and 4 are incorrect. Dantrolene (Dantrium) is prescribed for a client with a spinal cord injury for discomfort resulting from spasticity. The nurse tells the client about the importance of follow-up and the need for which blood study?