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Pharmacology Test 1 Bank comprehensive

study guide for exam revision use

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1.The nurse is teaching a patient how a medication works to treat an illness. To do this, the nurse will rely on knowledge of which topic?: Pharmacotherapeutics 2.What is a desired outcome when a drug is described as easy to administer?- : It enhances patient adherence to the drug regimen. 3.A patient tells the nurse that an analgesic he will begin taking may cause drowsiness and will decrease pain up to 4 hours at a time. Based on this understanding of the drug's effects by the patient, the nurse will anticipate which outcome?: Improved compliance with the drug regimen. 4.A patient is using a metered-dose inhaler containing albuterol for asth- ma. The medication label instructs the patient to administer "2 puffs every 4 hours as needed for coughing or wheezing." The patient reports feeling jittery

2 / 45 sometimes when taking the medication, and she doesn't feel that the medication is always effective. Which action is outside the nurse's scope of practice?: Suggesting that the patient use one puff to reduce side effects. 5.A postoperative patient is being discharged home with acetaminophen for pain. the patient asks the nurse about using Tylenol for fever. Which statement by the nurse is correct?: "Taking the two medications together poses a risk for drug toxicity" 6.The nurse is preparing to care for a patient who will be taking an antihyper- tensive medication. Which action by the nurse is part of the assessment step of the nursing process?: Questioning the patient about OTC use 7.A postoperative patient reports pain, which the patient rates as an 8 on a scale of 1 to 10. The prescriber has ordered acetaminophen 650mg PO every 6 hours PRN. What will the nurse do?: Contact the provider to request a different analgesic medication. 8.A patient newly diagnosed with diabetes is to be discharged from the hospital. The nurse teaching the patient

3 / 45 about home management should begin by doing what?: Asking the patient to demonstrate how to measure and administer insulin. 9.The nurse receives an order to give morphine 5 mg IV every 2 hours PRN for pain. Which action is not part of the 6 rights of med adm?: Assessing the patient's pain level 15 to 30 minutes after giving the medication. 10.A patient tells a nurse that a medication prescribed for recurrent migraine headaches is not working. What will the nurse do?: Ask the patient about the number and frequency of tablets taken. 11.A nurse is preparing to administer medications. Which patient would the nurse consider to have the greatest predisposition to an adverse reaction?: A 30 y/o man with kidney disease 12.A nurse consults a drug manual before giving a medication to an 80 y/o patient. The manual states that older-adult patients are at increased risk for hepatic side effects. Which action by the nurse is correct?: Contact the provider to discuss an

4 / 45 order for pretreatment laboratory work. 13.A patient has been receiving IV penicillin for pneumonia for several days and begins to complain of generalized itching. The nurse auscultates bilateral wheezing and notes a temperature of 38.5 C (101F). Which action by the nurse is correct?: Hold the next dose and notify the prescriber of the symptoms 14.A postoperative patient has orders for morphine sulfate 1 to 2 mg IV every hour PRN for severe pain and acetaminophen- hydrocodone (Lortab) 7.5 mg PO every 4-6 hours PRN for moderate pain. The patient reports pain at a level of 8. Which action by the nurse is appropriate?: Administer morphine sulfate 2 mg IV and evaluate the patient's pain in 15-30 minutes 15.The nurse is teaching a patient about home administration of insulin to treat DM. As part of the teaching, the patient and nurse identify goals to maintain specific blood glucose ranges. This represents which aspect of the nursing process?: Planning 16.A nurse educator is conducting a continuing education class on pharma- cology. To evaluate the learning of the nurses in the class, the nurse educator asks, "Which drug name gives

5 / 45 information about the drug's pharmacologic classification? What is the correct response?: Amoxicillin 17.The FDA Amendments Act was passed in 2007 to address which aspect of drug safety?: Evaluating drug safety information that emerges after a drug has been approved and is in use 18.A nursing students asks a nurse about pharmaceutical research and wants to know the purpose of randomization in drug trials. The nurse explains that the randomization is used to do what?: To ensure that differences in outcomes are the result of the treatment and not differences in subjects. 19.Someone asks a nurse about a new drug that is in preclinical testing and wants to know why it cannot be used to treat a friend's illness. Which statement by the nurse is correct?: At this stage of drug development, the safety and usefulness of the medication is unknown. 20.A patient asks a nurse why drugs that have been approved by the FDA still have unknown side effects. What will the nurse tell the patient?: Subjects in drug trials do not always represent the full spectrum of possible patients.

6 / 45 21.A nurse is teaching nursing students about the use of nonproprietary names for drugs. The nurse tells them which fact about nonproprietary names?: They are assigned by the US Adopted Names Council 22.A patient tells the nurse that the oral drug that has been prescribed has caused a lot of stomach discomfort in the past. what will the nurse ask the prescriber?: Whether an enteric- coated form of the drug is available 23.A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely?- : Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body 24.A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?: Monitor plasma drug levels. 25.A patient is given a prescription for azithromycin and asks

7 / 45 the nurse why the dose on the first day is twice the amount of the dose on the next 4 days. Which reply is correct?: A large initial dose helps to get the drug to optimal levels in the body faster. 26.A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply?: This route is safer, less expensive, and more convenient. 27.The nurse is preparing to administer penicillin G intramuscularly to a child. The child's parents ask why the drug cannot be given in an oral liquid form. What is the nurse's reply?: This drug would be inactivated by the enzymes in the stomach. 28.A provider has written an order for a medication: drug A 100 mg PO every 6 hours. The half-life for the drug is approximately 6 hours. The nurse is preparing to administer the first dose at 8:00 AM on Tuesday. On Wednesday, when will the serum drug level reach plateau?: 8:00 AM 29.An adult male patient is 1 day postoperative from a total hip replacement. On a pain scale of 0 to 10, with 10 being the greatest pain, the patient reports a pain level of 10. Which medication would be most appropriate for the nurse to

8 / 45 administer to this patient?: 6 mg morphine sulfate IV 30.A nurse is explaining drug metabolism to a nursing student who asks about glucuronidation. The nurse knows that this is a process that allows drugs to be:: Recycled via the enterohepatic recirculation to remain in the body longer. 31.A patient is receiving IV gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and the medication has been tolerated by this patient in the past. Which could be a probable cause of the test result?: Patient is taking another medication that binds to serum albumin.

9 / 45 32.The nurse is caring for a child who has ingested a toxic amount of aspirin. The provider orders an IV drug that will increase pH in the blood and urine. the nurse understands that this effect is necessary to:: Increase the urinary excretion of aspirin 33.A patient is taking a drug that does not bind to albumin. Which aspect of renal drug excretion is affected by this characteristic?: Glomerular flitration 34.A patient is receiving digoxin twice daily. When assessing the patient before giving a dose, the nurse counts a pulse of 60 bpm and learns that the patient is experiencing nausea. The nurse consults a drug manual and verifies that the ordered dose is correct. What should the nurse do?: Contact the prescriber to report the symptoms 35.A patient reports becoming "immune" to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:: Desensitization of receptor sites by continual exposure to the drug 36.A patient has been receiving an antibiotic with a small

10 / 45 therapeutic index for 10 days. Upon assessment, the nurse notes an increase in the drug's side effects. What would be the nurse's priority action?: Ask the prescriber to order a plasma drug level test 37.A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine?: It is selective to receptors that regulate more than one body process. 38.What occurs when a drug binds to a receptor in the body?: It increases or decreases the activity of that receptor. 39.the nurse administer's naloxone to a patient who has received a toxic dose of morphine sulfate. The nurse understands that the naloxone is effective because of which action?: Preventing activation of opioid receptors by neuro- chemical alterations 40.The nurse is teaching a patient about taking warfarin and asks if the patient takes aspirin. This assessment by the nurse reflects a knowledge of which type of drug interaction?: Potentiative effects

11 / 45 41.A young adult postoperative patient is receiving morphine 2 to 4 mg IV every 2 hours PRN pain. The last dose was 3 mg given 2 hours ago. The patient is asleep, and the nurse notes a heart rate of 86 beats per minute and a respiratory rate of 8 breaths per minute. Which PRN medication will the nurse give this patient?: Naloxone to block the effects of morphine 42.In a discussion of drug-drug interactions, which would be the best exam- ple of a beneficial inhibitory interaction?: Naloxone blocking morphine sulfate's action 43.A patient is taking drug X and receives a new prescription for drug Y, which is listed as an inducing agent. The nurse caring for this patient understands that this patient may require doses of drug : Higher; X 44.A patient taking oral contraceptives thinks she may be pregnant. As part of the patient's history, what will the nurse ask?: Do you take seizure medication? 45.A child ingests a parent's aspirin tablets, and the prescriber orders sodium bicarbonate to block the toxic effects of the aspirin. The nurse caring for

12 / 45 this patient knows that sodium bicarbonate is effective against the aspirin because it:: Raises the pH of the interstitial fluid to facilitate passage out of the cells. 46.Which statement about food and drug interactions is true?: Some foods can inhibit CYP isoenzymes and alter drug metabolism. 47.A nurse is teaching a patient about a prescription that induces P-glyco- protein. The nurse will explain that this drug may cause which effect on other drugs?: Decreased elimination through the kidneys 48.A patient is given a new medication and reports nausea within an hour after taking the drug. The nurse consults the drug information manual and learns that nausea is not an expected adverse effect. When the next dose is due, what will the nurse do?: Administer the drug and tell the patient to report further nausea 49.A patient is being discharged after surgery. During the admission history, the nurse learned that the patient normally consumes 2 or 3 glasses of wine a day. The prescriber has ordered hydrocodone with acetaminophen for pain. What will

13 / 45 the nurse do?: Tell the patient not to drink wine while taking this. 50.A nurse is reviewing a MAR before administering medications. Which order will the nurse implement.: Furosemide (Lasix) 20 mg PO daily 51.A patient is given a drug for the first time and develops SOB. The patient's HR is 76, RR is 20, and BP is 120/70; the nurse checks the drug administration manual to make sure the correct dose was given and learns that some patients taking the drug experience SOB. The nurse will contact the provider to report what?: A side effect 52.A nurse is preparing to give an antibiotic to a patient who reports being allergic to antibiotics. Before giving the med, what will the nurse do?: Ask whether the patient has taken this antibiotic for other infections 53.A nurse is preparing to administer a drug. Upon reading the medication guide, the nurse notes that the drug has been linked to symptoms of Parkin- son's disease in some patients. What will the nurse do?: Observe the patient closely for such symptoms and prepare to treat them if needed.

14 / 45 54.A nurse provides teaching to a patient who will begin taking a drug with a known risk of hepatotoxicity. Which statement by the patient indicates a need for further teaching?: Routine testing and early detection of problems will prevent liver failure. 55.A patient is taking sertraline (Zoloft) for depression, and the provider orders azithromycin to treat an infection. What will the nurse do?: Contact the provider to discuss an alternative to azithromycin. 56.A patient is taking a drug that has known toxic side effects. What will the nurse do?: Monitor the function of all organs potentially affected by the drug. 57.A nursing student is preparing to give a medication that has a boxed warning. The student asks the nurse what this means. What will the nurse explain about boxed warnings?: They alert prescribers to measures to mitigate potential harm from side effects. 58.A postoperative patient who is worried about pain control will be dis- charged several days after surgery. The nurse providing discharge teaching tells the patient that the

15 / 45 prescribed Lortab is not as strong as the morphine the patient was given in the immediate postoperative period. Which response is the patient likely to experience?: A negative placebo effect when taking the medication 59.A nurse administers the same medication in the same preparation in the same dose to several patients and notes that some patients have better response to the drug than others. What is the most likely explanation for this phenomenon?: Pharmacogenomic differences among individuals 60.The US FDA recommends genetic testing of patients receiving certain medications. Genetic testing helps prescribers:: Determine whether a patient is a rapid or slow metabolizer of the drug 61.A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's:: Metabolism of drugs 62.A nurse is preparing to care for a patient who is receiving digoxin. When screening for potential adverse effects from

16 / 45 this drug, the nurse will review which of the patient's laboratory results?: Serum electrolytes 63.A patient has been taking narcotic analgesics for chronic pain for several months. The nurse caring for this patient notes that the prescribed dose is higher than the recommended dose. The patient has normal VS, is awake and alert, and reports mild pain. What does the nurse recognize about this patient?: This patient has developed pharmacodynamic tolerance, which has in- creased the minimal effective concentration needed for analgesic effect. 64.A nurse is caring for a woman with breast cancer who is receiving tamox- ifen. A review of this patient's chart reveals a deficiency in the CYP2D6 gene. The nurse will contact the provider to suggest:: A different medication

17 / 45 65.A nurse is teaching a group of woman about medications. The women want to know why so many drugs have unpredictable effects in women. The nurse will tell them that:: Most known drug effects are based on drug trials in men 66.The nurse is assesing a newly admitted older patient who has recently lost 15 lbs. The nurse notes that the patient is taking Warfarin. Which laboratory result will the nurse discuss with the provider?: Serum albumin and coagulation studies 67.A nurse is caring for a patient and her newborn immediately after delivery. The patient's medication history includes prenatal vitamins, one or two glass- es of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and VI morphine-during labor. What will the nurse expect to do?: Monitor the infant's respirations and prepare to administer naloxone if needed. 68.A patient who has just learned she is pregnant has stopped using a pre- scription medication that she takes for asthma because she doesn't want to harm her baby. What will the

18 / 45 nurse tell her?: That her baby's health is dependent on hers 69.A nurse is teaching a class to a group of pregnant patients. The nurse cor- rectly teaches that the highest risk of teratogen- induced gross malformations exists during what time?: During the first trimester 70.A pregnant patient in active labor is admitted to the ED. a toxicology screen and a physical assessment reveal that the patient is an active heroin addict. The nurse who cares for the neonate after delivery should anticipate which clinical manifestation?: A shrill cry and irritability 71.A patient has just given birth to a baby boy with a cleft palate. The nurse will review the patient's medication history with special emphasis on drugs taken during which period?: During the first trimester 72.A pregnant patient asks the nurse about the safe use of medications during the third trimester. What will the nurse tell her about drugs taken at this stage?: They may need to be given in higher doses if they undergo renal clearance. 73.A woman who is breastfeeding her infant must take a

19 / 45 prescription medica- tion for 2 weeks. The medication is safe, but the patient wants to make sure her baby receives as little of the drug as possible. What will the nurse tell the patient to do?: Take the medication immediately after breastfeeding 74.Which type of drugs taken by a pregnant patient are more likely to have effects on the fetus?: Lipid-soluble drugs 75.A patient in her second trimester tells the nurse she is worried that a medication she took before knowing she was pregnant might have harmed the fetus. What will the nurse do?: Ask the patient what she took and when she learned she was pregnant. 76.A nursing student asks the nurse why more is not known about the teratogenic effects of maternal medication ingestion during pregnancy. Which response by the nurse is correct?: Clinical trials to assess this risk would put the fetus at risk. 77.An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant's parents ask the nurse about using a topical antihis- tamine. What should the nurse tell them?: Applying an antihistamine to the skin can cause toxicity in

20 / 45 this age group. 78.A pediatric nurse is teaching nursing students about medication adminis- tration in children. Which statement by a student indicates understanding?: - Drugs effective in adults may not work in children; even if the dose is proportional for weight and size. 79.The parents of the child with asthma ask the nurse why their child cannot use oral corticosteroids more often, because they are so effective. The nurse will offer which information that is true for children?: Chronic steroid use can inhibit growth. 80.Parents ask the nurse why an OTC cough suppressant with sedative side effects is not recommended for infants. Which response is correct?: Infants are more susceptible to central nervous system effects than are adults. 81.A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant's age and weight, the nurse gives the narcotic analgesic IV. When assessing the infant 15 minutes later, the nurse notes respirations of 22, and a HR of 110. The infant is asleep in the

21 / 45 parent's arms and does not awaken when VS are assessed. The nurse understands that these findings are a result of:: Immaturity of the blood-brain barrier in the infant 82.An infant is receiving a medication that has a narrow therapeutic range. the nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving this drug, the nurse will assess the infant for:: Signs of drug toxicity 83.A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to:: Order a dose that is lower than the adult dose 84.A pediatric nurse is teaching nursing students to calculate medication doses for children using a formula based on body surface area. Which state- ment by the nursing student indicates understanding of the teaching?: This

22 / 45 formula helps approximate the first dose, other doses should be based on clinical observations. 85.A child will receive 750mg of an antibiotic for 10 days. The child attends day care. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse discuss with the child's provider?: 500mg/5mL - 375mg PO twice daily 86.A nurse caring for a 5 y/o child notes that the child has discoloration of several teeth. When taking a medication history, the nurse will ask about which group of medications?: Tetracyclines 87.A nurse is teaching nursing students about pediatric medication adminis- tration. What will the nurse include when discussing pediatric drug research?- : Studies showed a significant percentage of unanticipated and potentially lethal side effects in children 88.A nurse is concerned about renal function in an 84 y/o patient who is taking several medications. What will the nurse assess?:

23 / 45 Creatinine clearance 89.A nurse is preparing to teach a forgetful older adult about a multiple drug regimen to follow after discharge from the hospital. To help promote adherence, what will the nurse do?: Cluster medication administration times as much as possible 90.A nurse is reviewing an older adult's chart before giving medications. Which patient information is of most concern?: Low serum albumin 91.Based on changes in hepatic function in older adult patients, which ad- justment should the nurse expect for oral medications that undergo extensive first-pass metabolism?: The interval between doses should be increased 92.A nurse is preparing to give medications to four older patients who are all taking multiple medications. Which patient is most likely to have an adverse drug reaction related to increased drug effects?: Thin patient with a chronically low appetite 93.A nurse is caring for an older adult during the immediate postoperative period after a total hip replacement. The surgeon has ordered meperidine (De- merol) for severe pain. What will

24 / 45 the nurse do?: Request an order for morphine instead of meperidine (Demerol) 94.An older adult is admitted to the hospital for treatment of an exacerbation of a chronic illness. Admission lab work reveals an extremely low serum drug level of the drug used to treat this condition. The patient has brought the medication to the hospital, along with other medications taken. The patient's renal and hepatic function tests are normal. What will the nurse suspect as a likely cause of this finding?: Financial concerns 95.A nurse is teaching a group of nursing students about administering medications to older adult patients. Which statement by a student indicates a need for further teaching?: Alteration in hepatic function requires more frequent dosing 96.A nurse is obtaining a drug history from an older adult who is taking multiple medications prescribed by different providers. Which two medica- tions taken together create a reason for concern?: Amitriptyline (Elavil) and diphenhydramine (Benadryl) 97.A nurse is making a home visit to an older adult woman who

25 / 45 was recently discharged home from the hospital with a new prescription. The nurse notes that a serum drug level drawn the day before was subtherapeutic. What will the nurse do next?: Count the pills in the prescription bottle 98.The nurse is teaching a group of nursing students about adherence to medication in older adults. Which statement by the student indicates under- standing?: The majority of older patients who do not adhere to drug regimens do so intentionally. 99.A patient receives morphine and shows signs of toxicity. The prescriber orders naloxone to reverse the effects of morphine. The nurse understands that the naloxone reverses morphine toxicity by which action on morphine receptor sites?: Preventing activation of receptors

100. A nurse is teaching a group of students about neuropharmacology. Which statement by the student about peripheral nervous system drugs indicates a need for further teaching?: Drugs affecting anoxal conduction have a variety of uses.
101. A nurse is preparing to administer a medication and learns that it is a nonselective agonist. What does the nurse