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Pharmacology MSN 571 practice questions
With Verified and Detailed Answers Latest
2025 Update!! Graded A+
A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill. Which action should the prescriber take initially? - Arrange to schedule an appointment with the patient. A metered-dose albuterol inhaler is prescribed for asthma management. The patient reports feeling jittery sometimes when taking the medication, and does not feel that the medication is always effective. Which action will the provider take to best minimize patient risks and maximize medication effectiveness? - Auscultate the patient's lung sounds and obtain other relevant vital signs. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding would be most concerning to the provider? - The patient drinks two glasses of wine every night. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital discharge. Which action by the provider will best support the patient's ability to effectively manage medication therapy? - Asking the patient to demonstrate how to measure and administer insulin A patient reports that a medication prescribed for recurrent migraine headaches is not working. Which action is the prescriber's priority when addressing the patient's concern? - Ask the patient about the number and frequency of tablets taken. The drug manual states that older adult patients are at increased risk for hepatotoxicity. Which action is most important when prescribing this medication to an 80-year-old patient? - Obtaining baseline liver function studies A patient with bipolar disorder is prescribed daily lithium. Which action is most important for the provider to take in order to determine if the therapeutic level is maintained? - Order periodic laboratory testing.
Which factor best supports an increase for full prescriptive authority for both advanced practice registered nurses (APRNs) and physician assistants (PAs)? - More patients will have access to health care. A pediatric patient prescribed ampicillin for streptococcal pharyngitis reports new onset of a pruritic, dull red, maculopapular rash on the chest and neck. Which action is most important for the provider to take to minimize this patient's risk for injury? - Discontinue the ampicillin. Which prescriber action will have the greatest impact on the patient's commitment to adherence to any type of medication therapy? - Providing medication education that the patient can easily understand Which patient statement suggests to the provider that the patient's nonadherence with their medication plan is related to dissatisfaction with the therapy? - "I've been taking this medication for well over a week and I lost only a half a pound." How can the prescriber's regular collaboration with a pharmacist improve positive outcomes for patients? - Pharmacists have additional information on drug interactions. The pharmacist can suggest adequate medication dosing. Pharmacists have firsthand knowledge of the facility formulary. Which statements made by the prescriber demonstrate an understanding of effective medication education? - "This medication needs to be stored in the refrigerator. "Take 3 tablets daily: 1 with breakfast, 1 with lunch, and one with dinner." "You need to take the medication as we discussed until all the tablets are gone." "Call the office immediately if you begin experiencing any itching, headache, or difficulty breathing." The patient who has been prescribed lithium for a diagnosis of bipolar disorder asks why blood tests are required on a regular basis. Which provider responses demonstrate an understanding of why the patient requires a variety of laboratory tests? - "We need to monitor how your thyroid is functioning." "We need to monitor kidney function while you are on this drug. This medication can cause you to lose sodium, so we need to measure sodium levels." When prescribing lovastatin, what will a provider advise to decrease the risk of developing muscle toxicity? - Substitute grapefruit juice with orange juice
A patient who has been taking sertraline for depression was prescribed azithromycin to treat an infection by a provider at an after-hours clinic. What action will the primary care provider take to address the risk this combination of medication has posed for the patient? - Discontinue the azithromycin and write an order for an alternative antibiotic. A patient reports mild nausea within an hour after taking the first two doses of a newly approved medication. Nausea is not listed among the known side effects of this drug. What instructions will the provider give the patient? - "Take the next dose with food and call the office if the nausea reoccurs or if other symptoms develop." A patient develops shortness of breath shortly after taking the initial dose of a newly prescribed medication. The patient's heart rate is 86 beats/minute, the respiratory rate is 24 breaths/minute, and the blood pressure is 120/70 mm Hg. The prescriber will discontinue the drug based on the assumption the patient experienced what medication induced effect? - A side effect A provider recommends genetic testing of a patient before prescribing a medication. What response should the provider give when asked by the patient about the purpose of genetic testing? - "Such testing will tell us how quickly your body is likely to metabolize, or process, the drug." A patient is prescribed digoxin. Which screening will the provider order to monitor for potential adverse effects from this drug? - Serum electrolytes A provider considers prescribing tamoxifen for a woman with breast cancer. Upon reviewing results of genetic testing, the prescriber notes that the patient has variations in the CYP2Dy allele resulting in a deficiency of the CYP2D6 isoenzymes. What action will this deficiency warrant in the prescribing of tamoxifen, a CYP2D substrate? - The tamoxifen will not be prescribed. A patient has taken a narcotic analgesic for chronic pain for several months. At a follow-up appointment, the provider notes that the patient has been taking more than the prescribed dosage. The patient has normal vital signs, is awake and alert, and reports mild pain. What does the provider suspect is responsible for the patient's response? - This patient has developed pharmacodynamic tolerance,
which has increased the minimal effective concentration (MEC) needed for analgesic effect Which patient ethnic ancestry creates a risk factor that may result in minimal beneficial response to tamoxifen therapy? - French Before initiating cetuximab therapy, the provider will order epidermal growth factor receptor (EGFR) testing for the patient having which condition? - Colorectal cancer When considering the benefit of pharmacogenomics, what information should the prescriber include when prescribing a new medication? - Provide definitions and possible examples of related idiosyncratic responses to this medication
- A provider has prescribed a female patient a medication that induces P- glycoprotein (PGP). The provider will be particularly concerned about which aspects of the patient's medical history? - Intestinal problems, Kidney function, Liver function When prescribing medications to infants, it is important for the provider to consider which fact? - Breast-feeding infants are more likely to develop toxicity when the mother is taking lipid-soluble drugs, Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. Infants have immature livers, which slows drug metabolism, Infants are more sensitive to medications that act on the central nervous system (CNS). What will the provider consider when prescribing two drugs that compete for plasma albumin receptor sites? - Binding of one or both agents will be reduced, Plasma levels of free drug will rise, Plasma levels of free drug will fall Which actions occur in most of the fatal medication errors? - Giving a drug intravenously instead of intramuscularly, Administering a drug that sounds like the prescribed drug, Writing a prescription illegibly A patient is found to have a genetic deficiency in the biomarker CYP2C19. The provider recognizes that prescribing clopidogrel will increase the patient's risk for developing what serious conditions? - Myocardial infarction, Stroke
Prescribe a dose that is relatively lower than an adult dose when adjusted for body surface area A pediatric provider is teaching nursing students to calculate medication doses for children using a formula based on body surface area. Which statement by a nursing student indicates understanding of the teaching? - "This formula helps approximate the first dose; other doses should be based on clinical observations." A child attending daycare is prescribed 750 mg of an antibiotic for 10 days. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the provider consider to best assure drug adherence? - 375 mg of a 500 mg/5 mL solution PO twice daily A 5-year-old has gray teeth. When taking a medication history, the provider will ask about previous use of which group of medications? - Tetracyclines A provider is concerned about renal function in an 84-year-old patient who is taking several medications. What laboratory result will the provider order? - Creatinine clearance An older adult patient with a history of forgetfulness will need to take multiple drugs after discharge from the hospital. What provider action will most successfully promote medication adherence in a forgetful patient? - Schedule medications to be taken at the same times as much as possible A provider is reviewing an older adult patient's chart during a routine visit. Which patient information is of most concern regarding the renewing of medication prescriptions for highly protein-bound drugs? - Low serum albumin Four older adult patients are taking multiple medications. For which patient is the provider most concerned about the risk for adverse drug effects? - An underweight patient with a chronically low appetite An older adult patient is entering into the immediate postoperative period after a total hip replacement. The patient's son concerned about related pain asks meperidine be prescribed since, "I had it for severe pain when I injured when I was younger." What action will the provider take to reduce the patient's risk for
injury while addressing the patient's pain? - Prescribe morphine and discuss the rationale with the patient's son. An older adult patient is admitted to the hospital for treatment of an exacerbation of a chronic illness. Admission laboratory work reveals an extremely low serum drug level of the drug used to treat this condition. The patient's renal and hepatic function tests are normal. What might the provider suspect as a likely cause of this finding? - Nonadherence to the medical regimen A provider obtains a drug history from an older adult who is a new patient. Of the multiple medications taken, which two, taken together, create a reason for concern? - Amitriptyline and diphenhydramine A frail older adult patient is admitted to the hospital after several days of vomiting, diarrhea, poor intake of foods and fluids, and anuria for 8 hours. What laboratory studies will the provider order to help guide medication administration?
- Creatinine clearance, Plasma drug levels, Serum albumin A patient has been taking oxycodone to manage severe, chronic pain for the last 6 months but now reports that it is no longer effective. The provider will discuss prescribing which medication for the patient? - Fentanyl transdermal patch A patient has been taking methadone for 5 months to overcome an opioid addiction. The provider will monitor the patient for which electrocardiographic change? - Prolonged QT interval A patient receives an epidural anesthetic during labor and delivery. What effect in the newborn in the immediate postpartum period must the provider be prepared to address? - Bradycardia A provider has prescribed the topical anesthetic lidocaine for a patient who has a second-degree burn on one arm. Which statement by the patient indicates understanding of the teaching regarding this treatment? - "I will apply a thin layer of the medication to only the burned area." Within a few minutes of administration a local anesthetic, the patient has a pulse of 54 beats/minute, respirations of 18 breaths/minute, and a blood pressure of
A patient asks why a combination product containing an opioid analgesic and a nonsteroidal antiinflammatory drug (NSAID) has been prescribed to manage cancer pain. Which response will the provider give the patient? - "The combination provides increased pain relief than when either product is used alone." A patient with cancer uses a fentanyl transdermal patch for pain relief. The patient reports having three or four episodes of severe pain lasting 30 minutes most days. What action will the provider take to address the patient's pain? - Prescribe a strong, short-acting opioid PRN. Oxycodone is ordered every 4 to 6 hours PRN for a patient newly diagnosed with cancer who is admitted to the hospital. The patient requests pain medication whenever reporting pain as a 7 or 8 on a scale of 1 to 10 (10 being the worst pain), but then tells the nurse the medication is not working well. What action will the provider take when learning of this situation? - Prescribe a fixed dosing schedule for the oxycodone. A patient who takes hydrocodone and ibuprofen for cancer pain is admitted to the hospital for chemotherapy. What action will the prescriber take regarding the prescribed ibuprofen. - Discontinues the ibuprofen. A patient with cancer has taken oxycodone and a nonsteroidal anti-inflammatory drug (NSAID) for a year. At a follow-up visit, the patient reports an increase in pain intensity with a new "burning and shooting" pain. What prescription will the provider write to address the patient's current pain? - A fentanyl transdermal patch, acetaminophen, and an adjunctive analgesic A patient newly diagnosed with cancer reports having pain at a level of 7 to 8 on a scale of 10. Which type of pain management will be prescribed initially by the provider to manage this patient's pain? - Opioid analgesics A patient with cancer who has been taking an opioid analgesic reports new onset pain at a new location even though the previous pain is well controlled. What will the provider suspect is the cause of this latest report of pain? - Infection or metastasis.
A patient reports "burning and shooting" foot pain alternating with sensations of numbness. Which medication will the provider discuss with the patient? - Imipramine A patient diagnosed with C. difficile infection is considered a high risk for recurrence. Which medication will the provider prescribed? - Bezlotoxumab The provider can prescribe a monoclonal antibody medication for the patient with which condition? - Psoriatic arthritis Which conditions may be treated with monoclonal antibody (mAb) therapy? - Breast cancer, Hemophilia, Asthma, Migraine headaches A provider, prescribing pain medication to each patient, will be most concerned about which patient developing a substance use disorder? - A patient whose history indicates the use of prescription narcotic analgesics for back and headache pain. What is the provider's ideal goal of drug rehabilitation? - Abstinence from the drug The provider is discussing the management of prescribed, controlled substances with a patient. Which statement by the patient indicates understanding of the information provided? - "Prescriptions for drugs in Schedules III and IV may be written to include up to 5 refills." A patient with alcohol abuse disorder is admitted to the hospital for surgery. The provider is most concerned when the admission interview determines the patient regularly used what medication? - Acetaminophen A young, unresponsive adult is brought to the emergency department by friends, who report, "He drank more than half of a large bottle of whiskey 3 hours ago." Assessment reveals a blood alcohol level of 0.32%. The vital signs are BP, 88/ mm Hg; R, 6/minute; T, 96.8F; and P, 76/minute and weak and thready. The provider will order which intervention to best minimize the patient's risk of renal failure? - Gastric lavage and dialysis
A patient who has a long-term addiction to opioids is believed to have taken an overdose of barbiturates. The provider will anticipate which likely outcome? - Pinpoint pupils, respiratory depression, and possibly coma A patient with opioid use disorder has undergone detoxification with buprenorphine. Afterward, the provider prescribes buprenorphine and naloxone. When the patient asks why the drug was changed, what response will the prescriber provide? - "This combination has a lower risk of abuse." A patient who arrives in the emergency department is difficult to arouse. The patient's friends volunteer that the patient took a handful of diazepam pills while at a party several hours ago. The provider will prescribe what medication to be administered? - Flumazenil A patient who is agitated, paranoid, and profoundly anxious is brought to the emergency department. The patient describes things in the room that do not exist. A cardiac monitor shows an irregular ventricular tachycardia. Which medication will the provider order to be administer? - Diazepam A young adult patient is admitted to the hospital for evaluation of severe weight loss. The patient demonstrates difficulty answering questions, and has trouble remembering simple details. The physical assessment reveals missing teeth and severe examples of tooth decay. Blood pressure is 160/98 mm Hg. The provider suspects abuse of which substance? - Methamphetamine A college student is brought to the emergency department after collapsing at a nightclub. The patient has a temperature of 105F, a clenched jaw, and confusion. Which medication will the provider prescribe? - Dantrolene A patient with opioid use disorder seeks treatment. When discussing the rationale for using methadone to ease opioid withdrawal, the provider explains that methadone has which pharmacologic property or characteristic? - It can prevent abstinence syndrome. A provider is conducting a smoking cessation class in the community. Which effects will be included in the discussion about physiologic effects of nicotine? - Increased blood pressure, Vomiting, Increased alertness, Suppression of appetite
A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths/minute, intercostal retractions, and frothy, pink sputum. After the patient's provider renders a diagnosis of heart failure, which diuretic will be prescribed to address these assessment findings? - Furosemide The provider orders furosemide for a patient who takes digoxin and is admitted to the hospital for treatment of heart failure. The morning assessment identifies an irregular heart rate of 86 beats/minute, a respiratory rate of 22 breaths/minute, and a blood pressure of 130/82 mm Hg. Crackles are heard in both lungs. Which laboratory result will be of greatest concern to the provider? - Potassium level of 3.4 mEq/L Verapamil is prescribed for the client who takes digoxin. The provider will monitor closely for which adverse reaction? - AV blockade Which medication will the provider prescribe for a patient admitted with severe hypertensive crisis? - Sodium nitroprusside IV A patient had a blood pressures of 150/95 mm Hg and 148/90 mm Hg on two separate office visits. This is consistent with a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. What will the patient's provider order to best manage the patient's hypertension? - A thiazide diuretic A patient with diabetes develops hypertension. Which type of medication will the provider prescribe to treat hypertension in this patient? - Angiotensin-converting enzyme (ACE) inhibitors A patient reports a family history of hypertension and cardiovascular disease but has no other risk factors. Current blood pressure is 126/82 mm Hg and the patient has a normal weight and body mass index for height and age. What will be the provider's focus when providing patient education? - The DASH diet, sodium restriction, and exercise A patient taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension tells the provider that she wants to become pregnant. What response
Azithromycin is prescribed for a patient who develops an infection. The patient's only other medication is simvastatin. Which patient symptom will create the greatest concern for the provider? - Muscle pain A patient with new-onset exertional angina has taken three nitroglycerin sublingual tablets at 5-minute intervals, but the pain has intensified. The patient has a heart rate of 76 beats/minute and a blood pressure of 120/82 mm Hg. The electrocardiogram is normal. The patient's lips and nail beds are pink, and there is no respiratory distress. The provider will prescribe what intervention? - Intravenous nitroglycerin and a blocker A patient who uses transdermal nitroglycerin for angina reports occasional periods of tachycardia. What intervention will the prescriber order? - Prescribe verapamil as an adjunct to nitroglycerin therapy. A patient presents to the emergency department after accidentally taking too much prescribed warfarin. The patient's heart rate is 78 beats/minute and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not report any pain. What will the provider order initially to address the patient's current condition? - A prothrombin time (PT) and an international normalized ratio (INR) A patient who has taken warfarin for a year has now been prescribed carbamazepine. What additional action will the provider take to assure the patient's safety? - Increase the dose of warfarin A patient has been receiving iron replacement therapy for 2 days after hip replacement surgery. The provider is alerted to the following assessment data: Patient's stools appear black. Patient is pale and reports feeling tired. Patient's heart rate is 98 beats/minute, respirations are 20 breaths/minute, and the blood pressure is 100/50 mm Hg. What order will the provider take initially to best assure appropriate care for this patient? - Hemoglobin and hematocrit (H&H) A patient is admitted to the hospital with a diagnosis of vitamin B12 deficiency, hypoxia and anemia. In addition to oxygen therapy, what will the provider order to address these problems? - IM cyanocobalamin and folic acid
Which conditions will the provider consider as a therapeutic use for verapamil? - Angina of effort, Cardiac dysrhythmias, Essential hypertension Amiodarone is prescribed for a patient. Which baseline tests will the prescriber order before this medication is started? - Chest radiograph, Ophthalmologic examination, Pulmonary function tests, Thyroid function tests A patient receiving heparin postoperatively to prevent deep vein thrombosis has a blood pressure of 90/50 mm Hg and a heart rate of 110 beats/minute. The patient's most recent aPTT is greater than 90 seconds. The patient reports lumbar pain. The provider will order what interventions initially? - Protamine sulfate, Discontinue heparin A patient arrives in the emergency department after becoming dehydrated. Based on the patient's history, the provider determines that isotonic dehydration has occurred. Which solution will be ordered to treat this patient? - 0.9% sodium chloride in sterile water A patient arrives in the emergency department reporting muscle weakness and drowsiness. The nurse notes a heart rate of 80 beats/minute, a respiratory rate of 18 breaths/minute, and a blood pressure of 90/50 mm Hg. The electrocardiogram reveals an abnormal rhythm. The provider will be most concerned about the patient's use of what medication? - Antacids While performing an admission assessment on a patient, the nurse learns that the patient is taking furosemide, digoxin, and spironolactone. A diet history reveals the use of salt substitutes. The patient appears confused and dyspneic and reports tingling of hands and feet. Which action will the provider take to provide effective patient care? - Prescribe both an electrocardiogram and serum electrolyte levels A patient collapses after running a marathon on a hot day and is brought to the emergency department to be treated for dehydration. The provider will prescribe which therapy? - Intravenous hypotonic fluids administered in stages A patient with a history of congestive heart failure is admitted to the hospital. The admission assessment and interview provides the following information: The patient is taking a thiazide diuretic and digoxin Admission electrolyte levels include a sodium level of 142 mEq/L, a chloride level of 95 mEq/L, and a potassium level of
A patient arrives in the emergency department reporting chest pain that has lasted longer than 1 hour and is unrelieved by nitroglycerin. The patient's electrocardiogram reveals elevation of the ST segment. Initial cardiac troponin levels are negative. The patient is receiving oxygen via nasal cannula. Which drug will the provider order to be given immediately? - Aspirin 325 mg chewable What is the most important question a provider should ask a patient before prescribing abciximab? - "Do you take any drugs that affect blood clotting?" A patient is considering getting epidural anesthesia during the delivery of her child. What consideration should the provider discuss with her to best assure the patient's informed consent? - Anesthetic drugs may enter systemic circulation and therefore reach the neonate The provider and a patient with a history of myocardial infarction should discuss the need to take which medications indefinitely? - Alteplase, Aspirin
