Pharmacology Exam 1: Questions and Answers, Exams of Pharmacology

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Rasmussen Pharm Exam 1 COMPLETE

QUESTIONS AND ANSWERS)

A patient asks the nurse about drug interactions with OTC preparations. What is the nurse's best response?

A. "Discuss this with the health care provider." B. "There are not many interactions, so don't worry about it." C. "Read the labels carefully, and check with your health care provider." D. "Avoid over-the-counter preparations." - ANSWER>>C. "Read the labels carefully, and check with your health care provider." The patient should always check with the healthcare provider prior to starting new medications, and since this is referring to OTCs, the patient should also read labels for interactions and contraindications.

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 - ANSWER>>•A. One. 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 nurse educator is reviewing medication metabolism at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages?

A. Increased renal excretion B. Increased medication-metabolizing enzymes C. Liver failure D. Hypertension - ANSWER>>C. Liver failure. Liver failure decreases metabolism and thus increases the concentration of a medication. This requires decreasing the dosage.

A nurse is teaching a client about transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands?

A. "It doesn't' matter if I clean the site before I apply the patch." B. "I will rotate the application sites weekly." C. "I will apply the patch to an area of skin with no hair."

D. "I will place the new patch on the site of the old patch." - ANSWER>>C. "I will apply the patch to an area of skin with no hair."The client should apply the patch to a hairless area of skin to promote absorption of the 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. Teach the client about the medication. B. Determine the dosage. C. Monitor for adverse effects. D. Lock compartments for controlled substances. E. Determine the client's insurance status. - ANSWER>>A. Teach the medication as part of the rights of medication administration.

C. Monitor for adverse effects as part of the rights of medication administration.

D. Lock controlled substances in a drawer, cart, or other compartment to prevent misuse.

A nurse is preparing to administer digoxin to a client who states, "I don't want to take that medication. I do not want one more pill." Which of the following responses should the nurse make?

A. "Your physician prescribed it for you, so you really should take it." B. "Well, let's just get it over quickly then." C. "Okay, I'll just give you your other medications." D. "Tell me your concerns about taking this medication." - ANSWER>>"Tell me your concerns about taking this medication." D. Although clients have the right to refuse a medication, this response is correct in determining the reason for refusal by asking about the client's concerns. Then information can be provided about the risk of refusal and facilitate an informed decision. At that point, if the client still exercises their right to refuse a medication, notify the provider and document the refusal and the actions taken.

A nurse is reviewing a client's prescribed medications. Which of the following situations represents a contraindication to medication administration?

A. The client drank grapefruit juice, which could reduce a medication's effectiveness. B. The medication has orthostatic hypotension as an adverse effect. C. A medication is approved for ages 12 and older, and the client is 8 years old. D. An antianxiety medication that has an adverse effect of drowsiness is prescribed as a preoperative sedative. - ANSWER>>C. Age is one factor that can be a contraindication to medication administration. Contraindications are findings that indicate the client should not receive a medication and are different from instances where an undesirable effect or more monitoring are needed.

A nurse is assessing a client before administering medications. Which of the following data should the nurse obtain? (Select all that apply.)

A. Use of herbal products B. Daily fluid intake C. Ability to swallow D. Allergies - ANSWER>>A. CORRECT: Inquire about the client's use of herbal products, which often contain caffeine, prior to medication administration because caffeine can affect medication biotransformation.

C. CORRECT: Determine the client's ability to swallow to see what route or formulation of the medication the client requires.

D. CORRECT: Inquire about food allergies during the preassessment to identify any potential reactions or interactions.

A nurse is working with a newly licensed nurse who is administering medications to clients. Which of the following actions should the nurse identify as an indication that the newly hired nurse understands medication error prevention?

A. Taking all medications out of the unit-dose wrappers before entering the client's room B. Checking the prescription when a single dose requires administration of multiple tablets C. Administering a medication, then looking up the usual dosage range D. Relying on another nurse to clarify a medication prescription - ANSWER>>B. Checking the prescription when a single dose requires administration of multiple tablets. If a single dose requires multiple tablets, it is possible that an error has occurred in the prescription or transcription of the medication. This action could prevent a medication error.

A nurse is caring for a client experiencing IV extravasation. The facility requires the administration of an antidote for the prescribed IV solution. After stopping the IV infusion, which of the following actions should the nurse take first?

A. Remove the IV catheter. B. Withdraw the solution from the IV access. C. Administer the antidote to the vesicant. D. Insert a new IV access in a different extremity. - ANSWER>>B. Withdraw the solution from the IV access. According to evidence-based practice, the nurse should first withdraw the solution from the IV access. This reduces the amount of vesicant in the body, and lowers the risk of tissue damage.

A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states when they took penicillin 3 years ago, they developed a rash. Which of the following actions should the nurse take?

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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. - ANSWER>>B. 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 reviewing a client's health record and notes that the client experienced 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. Gastrointestinal - ANSWER>>Central nervous. C. CORRECT: Realize that extrapyramidal effects are movement disorders that can be caused by a number of central nervous system medications (traditional/FGA antipsychotic medications).

A nurse is teaching a client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

A. Increase intake of protein-rich foods. B. Expect muscle twitching to occur. C. Take this medication with food. D. Anticipate relief of manifestations in 24 hr. - ANSWER>>C. The client should take this medication with food to reduce GI effects.

A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is oversedated. Which of the following medications should the nurse expect to administer to this client?

A. Ketamine B. Naltrexone C. Flumazenil D. Fluvoxamine - ANSWER>>C. CORRECT: Flumazenil is a competitive benzodiazepine antagonist used to reverse the sedation and other effects of benzodiazepines.

A nurse is teaching a client who has obsessive-compulsive disorder and has a new prescription for fluoxetine. 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." - ANSWER>>A. CORRECT: Fluoxetine can take 1 to 4 weeks before the client reaches full therapeutic benefit.

A nurse is caring for a client who has a new prescription for phenelzine, an MAOI, 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 - ANSWER>>A. CORRECT: 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. - ANSWER>>C. CORRECT: Changing positions slowly helps prevent orthostatic hypotension, which is an adverse effect of amitriptyline.

E. CORRECT: 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 can 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."

• ANSWER>>A. CORRECT: Decreased libido is a potential adverse effect of fluoxetine and other SSRIs

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. Tinnitus D. Rash - ANSWER>>B. CORRECT: 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 lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

A. Hold the medication and notify the provider. B. Prepare the client for hemodialysis. C. Administer an additional oral dose of lithium. D. Request a stat repeat of the laboratory test. - ANSWER>>A. CORRECT: Hold the medication and notify the provider is the appropriate action for a client who has severe toxicity, as evidenced by a plasma lithium level of 2.1 mEq/L.

A nurse is caring for a client who has a new prescription for lithium. 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. D. Limit aerobic activity in hot weather. - ANSWER>>D. CORRECT: The client should avoid activities that have the potential to cause sodium/water depletion, which can increase the risk for toxicity.

A nurse is assessing a client who takes lithium for the treatment of bipolar disorder. The nurse should identify which of the following findings is a possible indication of toxicity to this medication?

A. Severe hypertension B. Coarse tremors C. Constipation D. Muscle spasms - ANSWER>>B. CORRECT: Coarse tremors are an indication of toxicity

A nurse is preparing a teaching plan for a client who has bipolar disorder and a new prescription for carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

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 provider if you develop a rash." E. "Avoid driving for the first few days after starting this medication." - ANSWER>>B. CORRECT: Grapefruit juice affects carbamazepine metabolism and should be avoided.

C. CORRECT: 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. CORRECT: Carbamazepine can cause Stevens-Johnson syndrome, which can be fatal. The client should notify the provider promptly if a rash occurs. E. CORRECT: CNS effects (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 assessing a client who recently began taking haloperidol. Which of the following findings is the priority to report to the provider?

A. Constipation B. Neck spasms C. Drowsiness D. Sexual dysfunction - ANSWER>>B. CORRECT: Neck spasms are an indication of acute dystonia (EPS). The greatest risk to this client is respiratory insufficiency if the laryngeal muscles are also effected. Therefore, this is the priority finding to report.

A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? (Select all that apply.)

A. Lorazepam B. Diazepam C. Naltrexone D. Acamprosate - ANSWER>>A. CORRECT: Lorazepam is a benzodiazepine used during alcohol withdrawal to decrease anxiety and reduce the risk for seizures.

B. CORRECT: Diazepam is a benzodiazepine used during alcohol withdrawal to decrease anxiety and reduce the risk for seizures.

You have been assigned to care for Jim. He is 29 and has been diagnosed with schizophrenia. Jim has been prescribed chlorpromazine. He lives with his parents. You have been asked to talk with Jim's family. His parents have questions about the side effects of chlorpromazine. While Jim is in a group session, you meet with his parents. The mother asks what Jim's provider means by saying that chlorpromazine causes EPS. Which teaching statement by the nurse regarding EPS is INCORRECT? - ANSWER>>"There are many drugs to manage late EPS"

Jim's mom says that if these symptoms create problems, she wants to know what can be done to help the situation. Which response by the nurse would be appropriate? - ANSWER>>"Early EPS can be treated with anticholinergic drugs, beta blockers, or benzos"

Jim's mother states that she is concerned. "Understand that Jim will need to take the medication for the rest of his life. How am I ever going to get him to take these pills if the side effects are so bad?" Which teaching statement by the nurse is INCORRECT? - ANSWER>>"Adherence can be improved by hiding Jim's pills in his morning eggs."

You are a nursing student on your medical surgical rotation. Mrs. S. has been diagnosed with depression. As part of her treatment, she has been prescribed fluoxetine. Your clinical instructor has informed you that Mrs. S has many questions about the use of fluoxetine for the treatment of depression. Mrs. S asks: "How does fluoxetine work?" Which response by the nurse would be most appropriate? - ANSWER>>"Fluoxetine increases the concentration of serotonin in the synapse, minimizing the symptoms of depression."

Mrs. S asks "What else do I need to know about this medication?" Which statements are appropriate for the nurse to include in the teaching plan? SATA - ANSWER>>"This medication may cause some sexual side effects. Let your HCP know about this if it occurs" "When you stop taking this medication, you should not withdraw from it abruptly." "Let your family or HCP know if you are experiencing a worsening mood, agitation, or increased anxiety."

Mrs. S asks: "I've read about serotonin syndrome, is this something I should be concerned about?" Which teaching statement by the nurse regarding serotonin syndrome is INCORRECT?" - ANSWER>>"Serotonin syndrome usually begins after several weeks of treatment."

When developing a teaching plan, which statements about the treatment of bipolar disorder does the nurse identify as true? SATA - ANSWER>>Mood stabilizers are used to prevent recurrent manic- depressive episodes. Antidepressants should be used with mood stabilizers in the treatment of clients with bipolar depression. Lithium is a preferred mood stabilizer for BPD.

When developing a teaching plan, which teaching statement by the nurse regarding lithium is INCORRECT? - ANSWER>>"Lithium does not provide long-term prophylaxis against recurrence of mania or depression."

When developing a teaching plan, which of the following statements is true regarding required follow- up when a client is prescribed lithium? - ANSWER>>Therapeutic range needs to be routinely evaluated with a blood test.

You are working at a community wellness center for one of your clinical rotations. a 57 yr old woman, Ms. L, comes into the wellness center and asks to speak with you. She states that she cannot sleep and you begin to ask her questions about the nature of her sleep disturbance. Which response by the nurse would be most appropriate? - ANSWER>>It is important to collect baseline data about the nature of your sleep disturbances to determine the best possible treatment.

Ms. L sees the primary care provider at the wellness center and is prescribed triazolam to help with her sleep disturbance. As Ms. L is leaving the wellness center, she says to you, "Well, now that I have the pill, I'll be on my way. This is all I need." Which response by the nurse would be most appropriate? - ANSWER>>"It would be best for you to not rely on the drug alone to assist with sleep. If you have a minute, I'd like to review some healthy tips for getting a better night sleep."

Ms. L asks you another question, "Why wouldn't the prescriber give me a refill on this prescription?". Which response by the nurse would be most appropriate? - ANSWER>>Insomnia is usually self-limiting. Drug therapy should be short-term.

What can you tell me about paroxetine?....Which response by the nurse would be most appropriate? - ANSWER>>Paroxetine allows the brain to have increased levels of serotonin, which should lessen feelings of anxiety.

You are the nurse doing home visits in a retirement community. Your client is an 85 yr old man who has been diagnosed with Alzheimers disease. His adult children are with him for the visit. They want to know about the disease and what treatment options exist. After you explain the progression of the disease, they ask if it is curable. How should you ANSWER? - ANSWER>>There are medications that may help delay cognitive decline, but the disease is not curable.

Next, they ask how the drug done-evil can work to help his disease. How should you ANSWER? - ANSWER>>It prevents the breakdown of ACh, so more is available for transmitting nerve impulses.

They also asks what side effects they can expect Dad to have with donepezil. How should you ANSWER?

• ANSWER>>The most common effects are nausea and diarrhea, but vomiting, dyspepsia, dizziness, and headaches are also common.

Teaching statements about interferon that are CORRECT. - ANSWER>>Interferon beta is a naturally occurring glycoprotein within the body, interferon beta can decrease the frequency and severity of attacks, and interferon beta suppresses T-helper cell activity in the immune system.

Teaching statement about interferon beta that is INCORRECT - ANSWER>>Interferon beta prevents infections by strengthening the immune system

Your client asks what kind of side effects can I expect from the interferon beta? Which teaching statement by the nurse is INCORRECT? - ANSWER>>Interferon beta can cause influenza.

Which statement made by your client indicates a need for further teaching about reducing injection site reactions from interferon beta? - ANSWER>>"Applying a warm compress before giving he injection will reduce the risk of pain at the site."

You are the pediatric nurse caring for Missy, an 8 yr old girl who has been diagnosed with epilepsy. Missy will be hospitalized for at least 3 more days. Missy has been prescribed oxcarbazepine. You have been assigned to develop the initial teaching plan for Missy and her parents. Which statement made by the nurse best describes the goals of therapy with oxcarbazepine? - ANSWER>>"Our goal is to reduce your seizures to an extent that helps you live a normal life."

Which teaching statement by the nurse is incorrect regarding the need to follow the established time frames for drug administration? - ANSWER>>In the event that she develops unpleasant side effects, the drugs can be withheld for up to three days as long as there have not been any recent seizures.

Which teaching statement by the nurse promotes client and family involvement in ensuring the treatment plan best meets Missy's needs? - ANSWER>>Suggest they keep a seizure chart to note the date, time, and nature of all seizure events.

Which statement made by the nurse would be inappropriate to include in the teaching plan for this client? - ANSWER>>"Take the medication with a glass of grapefruit juice each morning."

My son is John Smith. He is 8 yrs old and the dr put him on methylphenidate. He has been on it for 10 days now. John weighs 62lbs and when my friends son went on methylphenidate he lost weight. Will this happen to John? Which response by the nurse is most appropriate? - ANSWER>>"Giving John his first dose of methylphenidate after breakfast and his second dose in the early afternoon is the most effective strategy for preventing weight loss."

Why aren't the pills making it easier for him to sleep? Which teaching statement by the nurse is INCORRECT? - ANSWER>>"Your child probably is not sleeping because he plays too many video games. If you take away his video games, he should begin to sleep better."

The parent states, "I'm just going to stop the pills. I don't care what the doctor says. I think the pills aren't good for him." Which response by the nurse would be appropriate? - ANSWER>>"You should discuss your concerns with John's provider. Discontinuing medications suddenly can lead to extreme fatigue and depression."

Characteristics to consider in pharmacology - ANSWER>>Effectiveness, safety, selectiveness Maximum benefit with minimal harm

Properties to Consider in pharmacology - ANSWER>>Can the patient afford the medication? Can the patient physically take the medication? Will this medication interact with other medications the patient is taking?

5 rights of medication administration - ANSWER>>right patient, right drug, right dose, right route, right time

Medication Errors Stats - ANSWER>>According to an FDA 2016 update, medication errors injure approximately 1.3 mil people each year. John Hopkins researchers estimate 400,000 deaths annually from errors

What medications can't be crushed? - ANSWER>>time released: XR, XL, SR, ER

Pharmacokinetic - ANSWER>>Process whereby drugs move throughout the body (absorption, distribution, metabolism, and excretion) to achieve drug action.

Absorption - ANSWER>>movement of a drug from it's site of administration into the bloodstream