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NR293 Pharmacology Final Exam review -with 100% verified solutions2023-2024 1) A nurse, Exams of Health sciences

Chamberlain College of Nursing Health sciences

NR293 Pharmacology Final Exam review -with 100% verified solutions-2023-2024 1) A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose? a) Insomnia i) Rationale: Levothyroxine overdose will result in manifestations of hyperthyroidism, which include Insomnia, tachycardia, and hyperthermia. b) Constipation i) Rationale: Constipation is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. c) Drowsiness

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NR293 Pharmacology Final Exam review -with 100%

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1) A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that

which of the following findings is a manifestation of levothyroxine overdose?

a) Insomnia

i) Rationale: Levothyroxine overdose will result in manifestations of

hyperthyroidism, which include Insomnia, tachycardia, and

hyperthermia.

b) Constipation

i) Rationale: Constipation is a manifestation of hypothyroidism and indicates an

inadequate dose of levothyroxine.

c) Drowsiness

i) Rationale: Drowsiness is a manifestation of hypothyroidism and indicates an

inadequate dose of levothyroxine.

d) Hypoactive deep-tendon reflexes

i) Rationale: Hypoactive deep-tendon reflexes are manifestations of hypothyroidism

and indicate an inadequate dose of levothyroxine.

2) A nurse is reviewing the medical record of a client who has been on levothyroxine for

several months. Which of the following findings indicates a therapeutic response to the

medication?

a) Decrease in level of thyroxine (T4)

i) Rationale: If the dose of this medication has been adequate, the nurse should see

an increase in the T4.

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A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose? a) Insomnia i) Rationale: Levothyroxine overdose will result in manifestations of hyperthyroidism, which include Insomnia, tachycardia, and hyperthermia. b) Constipation i) Rationale: Constipation is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. c) Drowsiness i) Rationale: Drowsiness is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. d) Hypoactive deep-tendon reflexes i) Rationale: Hypoactive deep-tendon reflexes are manifestations of hypothyroidism and indicate an inadequate dose of levothyroxine.
A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication? a) Decrease in level of thyroxine (T4) i) Rationale: If the dose of this medication has been adequate, the nurse should see an increase in the T4.

b) Increase in weight i) Rationale: If the dose of this medication has been adequate, the nurse should see a decrease in weight, as hypothyroidism causes a decrease in metabolism with weight gain. c) Increase in hr of sleep per night i) Rationale: If the dose of this medication has been adequate, the nurse should see a decrease in the hr of sleep per night, as hypothyroidism causes sluggishness with increased hr of sleep. d) Decrease in level of thyroid stimulating hormone (TSH). i) Rationale: In hypothyroidism, the nonfunctioning thyroid gland is unable to respond to the TSH, and no endogenous thyroid hormones are released. This results in an elevation of the TSH level as the anterior pituitary continues to release the TSH to stimulate the thyroid gland. Administration of exogenous thyroid hormones, such as levothyroxine, turns off this feedback loop, which results in a decreased level of TSH.

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance? a) Ranitidine i) Serum creatinine levels b) Guafenesin i) Drowsiness and dizziness c) Prednisone i) Glucose intolerance and hyperglycemia, patient might require increased dosage of hypoglycemic med. d) Atorvastatin i) Thyroid function tests.

A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The client tells the nurse she is experiencing flank pain. Which of the following adverse effects should the nurse suspect? a) Renal stones
A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? a) Hemoglobin b) Prothrombin time (PT) i) Rationale: This test is used to monitor warfarin therapy. For a client receiving full anticoagulant therapy,should typically be approximately two to three times the normal value, depending on the indication for therapeutic anticoagulation. c) Bleeding time d) Activated partial thromboplastin time (aPTT)
A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream? a) Glucose b) Ammonia i) Rationale: Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma.

c) Potassium d) Bicarbonate

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." b) "Clients who have rheumatoid arthritis should not take warfarin." c) "Clients who are pregnant should not take warfarin." i) 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."
A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching? a) "I have started taking ginger root to treat my joint stiffness." i) Rationale: Ginger root can interfere with the blood clotting effect of warfarin and place the client at risk for bleeding. This statement indicates the client needs further teaching. b) "I take this medication at the same time each day." i) Rationale: The client should take warfarin at the same time each day to maintain a stable blood level. c) "I eat a green salad every night with dinner." i) Rationale: Green leafy vegetables are a good source of vitamin K, which can interfere with the clotting effects of warfarin. Clients who are taking warfarin do not need to restrict dietary vitamin K intake but rather should maintain a consistent intake of vitamin K in order to control the therapeutic effect of the medication. d) "I had my INR checked three weeks ago. i) " Rationale: Clients who have been taking warfarin for more than 3 months should have their INR level checked every 2 to 4 weeks.
A patient is starting warfarin (Coumadin) therapy as part of treatment for atrial fibrillation. The nurse will follow which principles of warfarin therapy? (Select all that apply.)

A nurse is caring for a client who has active pulmonary tuberculosis (TB) and is to be started on intravenous rifampin therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? a) Constipation b) Black colored stools c) Staining of teeth d) Body secretions turning a red-orange color i) Rationale: Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva
A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? a) A. Check the client's vital signs. i) Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. Assess for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm. b) Request a dietitian consult. c) Suggest that the client rests before eating the meal. d) Request an order for an antiemetic.
A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide? a) "Crushing the medication might cause you to have a stomachache or indigestion.

i) Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing destroys protection. b) "Crushing the medication is a good idea, and I can mix it in some ice cream for you.” c) "Crushing the medication would release all the medication at once, rather than over time." d) "Crushing is unsafe, as it destroys the ingredients in the medication."

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? a) "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." b) "A pharmacist is the person to answer that question." c) "Heparin does not dissolve clots. It stops new clots from forming." i) Rationale: This statement accurately answers the client's question. d) "The oral medication you will take after this IV will dissolve the clot.
A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed? a) Thyroid hormone assay i) Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction. b) Liver function tests: i) Rationale: LFTs must be monitored before and during valproic acid therapy c) Erythrocyte sedimentation rate i) Rationale: This is not a necessary test related to lithium therapy. d) Brain natriuretic peptide
A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

1. A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy-induced nausea. For which of the following adverse effects should the nurse monitor? a) Headache Rationale: Headache is a common adverse effect of ondansetron. Analgesic relief is often required. b) Dependent edema c) Polyuria. d) Photosensitivity
A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? a) Hyperthermia b) Hypotension i) Rationale: Verapamil, a calcium channel blocker, can be used to control supraventricular tachyarrhythmias. It also decreases blood pressure and acts as a coronary vasodilator and antianginal agent. A major adverse effect of verapamil is hypotension; therefore, blood pressure and pulse must be monitored before and during parenteral administration. c) Ototoxicity d) Muscle pain
A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client? a) Constipation

i) Rationale: Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed b) B. Metallic taste c) Headache d) Muscle spasms

A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? a) Hyperglycemia b) Adrenocortical insufficiency i) Rationale: Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certain forms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and an abrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency. c) Severe dehydration d) Rebound pulmonary congestion
A nurse is preparing a client for surgery. Prior to administering the prescribed hydroxyzine, the nurse should explain to the client that the medication is for which of the following indications? (Select all that apply.) a) Controlling emesis b) Diminishing anxiety c) Reducing the amount of narcotics needed for pain relief d) Preventing thrombus formation e) Drying secretions

A nurse is caring for a client who has poison ivy and is prescribed diphenhydramine. Which of the following instructions should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine? a) Administer the medication with food b) Chew on sugarless gum or suck on hard, sour candies i) Rationale: Clients who report dry mouth can get the most effective relief by sucking on hard candies (especially the sour varieties that stimulate salivation), chewing gum, or rinsing the mouth frequently. It is the local effect of these actions that provides comfort to the client. c) Place a humidifier at your bedside every evening d) Discontinue the medication and notify your provider
A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? a) An excess amount of doxorubicin can lead to myelosuppression. b) Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. c) An excess amount of doxorubicin can lead to cardiomyopathy. i) Rationale: Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it. The maximum cumulative dose a client should receive is 550 mg/m or 450 mg/m with a history of radiation to the mediastinum. d) Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.

A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? a) An excess amount of doxorubicin can lead to myelosuppression. b) Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. c) An excess amount of doxorubicin can lead to cardiomyopathy. i) Rationale: Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it. The maximum cumulative dose a client should receive is 550 mg/m or 450 mg/m with a history of radiation to the mediastinum. d) Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.
A nurse at an ophthalmology clinic is providing teaching to a client who has open angle glaucoma and a new prescription for timolol eye drops. Which of the following instructions should the nurse provide? a) The medication is to be applied when the client is experiencing eye pain. b) The medication will be used until the client's intraocular pressure returns to normal. c) The medication should be applied on a regular schedule for the rest of the client's life. i) Rationale: Medications prescribed for open angle glaucoma are intended to enhance aqueous outflow, or decrease its production, or both. The client must continue the eye drops on an uninterrupted basis for life to maintain intraocular pressure at an acceptable level.

the nurse. The client might be taking an antacid because he is experiencing one or more of these manifestations. c) "I've lost 2 pounds since my appointment 2 weeks ago." d) "The naproxen is easier to take when I crush it and put it in applesauce."

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching? a) "I will notify my doctor before taking any other medications." b) "I have made an appointment to see my dentist next week." c) "I know that I cannot switch brands of this medication." d) "I'll be glad when I can stop taking this medicine." i) Rationale: Phenytoin is an anticonvulsant used to treat various types of seizures. Clients on anticonvulsant medications commonly require them for lifetime administration, and phenytoin should not be stopped without the advice of the client's provider.
A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching? a) The client holds his breath for 10 seconds after inhaling the medication. i) Rationale: The medication should be retained in the lungs for a minimum of 10 seconds so the maximum amount of the dosage can be delivered properly to the airways. To use the inhaler, the client exhales normally just prior to releasing the medication, inhales deeply as the medication is released, then holds the medication in the lungs for approximately 10 seconds prior to exhaling. b) The client takes a quick inhalation while releasing the medication from the inhaler. c) The client exhales as the medication is released from the inhaler. i) Rationale: Exhaling as the medication is released from the inhaler means that no medication will reach the client's bronchioles. The client should inhale slowly as the medication is released from the inhaler. d) The client waits 10 min between inhalations.

i) Rationale: The client should wait approximately 20 to 30 seconds between inhalations of the same medication, and 2 to 5 minutes between inhalations of different medications for maximum benefit.

A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching? a) “If my breathing begins to feel tight, I will use the cromolyn immediately.” b) “I will be sure to take the albuterol before taking the cromolyn.” i) Rationale: The client should always use the bronchodilator (albuterol) prior to using the leukotriene modifier (cromolyn). Using the bronchodilator first allows the airways to be opened, ensuring that the maximum dose of medication will get to the client's lungs. c) “I will use both medications immediately after exercising.” d) “I will administer the medications 10 minutes apart.”
A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? a) "I can walk a mile a day." b) "I've had a backache for several days." c) "I am urinating more frequently." d) "I feel nauseated and have no appetite." Rationale: Anorexia, nausea, vomiting, and abdominal discomfort are early signs of digoxin toxicity.
A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication?

liver, increasing peripheral sensitivity to insulin, and stimulating the release of insulin from the functioning beta cells of the pancreas. c) "Glipizide replaces insulin that is not being produced by your pancreas." d) "Glipizide prevents your liver from destroying your insulin.”

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? a) "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." Rationale: Heparin and warfarin are both anticoagulants that decrease the clotting ability of the blood and help prevent thrombosis formation in the blood vessels. However, these medications work in different ways to achieve therapeutic coagulation and must be given together until therapeutic levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to 5 days. When the client's PT and INR are within therapeutic range, the heparin can be discontinued. b) "I will call the provider to get a prescription for discontinuing the IV heparin today." Rationale: Discontinuing the IV heparin is not indicated at this time. c) "Both heparin and warfarin work together to dissolve the clots."
A nurse in a critical care unit is caring for a client who is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed? a) Prone

b) On the nonoperative side c) Sims' d) Semi-Fowler's

A nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. The client is receiving lidocaine IV at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? a) Prevents dysrhythmias i) Rationale: Lidocaine is an antidysrhythmic medication that delays the conduction in the heart and reduces the automaticity of heart tissue. b) Slows intestinal motility c) Dissolves blood clots d) Relieves pain
A nurse is providing teaching for a client who has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide? a) Take the medication on an empty stomach to decrease gastrointestinal irritation. b) Take the medication with orange juice to enhance absorption. i) Take between meals for optimal absorption i) Rationale: Ascorbic acid (vitamin C), which is found in orange juice, will enhance the absorption of iron and increase its bioavailability. This will also help to decrease the gastrointestinal side effects of iron. c) Take the medication with milk. d) Rinse the mouth before taking the iron.

NR293 Pharmacology Final Exam review -with 100% verified solutions2023-2024 1) A nurse, Exams of Health sciences

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Download NR293 Pharmacology Final Exam review -with 100% verified solutions2023-2024 1) A nurse and more Exams Health sciences in PDF only on Docsity!

NR293 Pharmacology Final Exam review - with 100%

verified solutions- 2023 - 2024