PHARMACOLOGYPre Test A

1. A 20 y/o client visiting the clinic requests the use of oral contraceptives. When reviewing the client’s history, which of the following would alert the nurse to a possible contraindication to using these agents?

a. Thrombophlebitis

b. UTI

c. Ulcerative colitis

d. Menorrhagia

2. A 30 y/o multipara has been prescribed oral contraceptives as a method of birth control. The nurse instructs the client that decreased effectiveness may occur if the client is prescribed which of the following?

a. Indomethacin (Indocin)

b. Amitiptyline (Elavil)

c. Ampicillin

d. Omeprazole (Prilosec)

3. A primigravid client in active labor has just received an epidural block for pain. After administration of the epidural block, for which of the following would the nurse frequently assess the client?

a. spinal headacheb. Hypotensionc. hyperreflexiad. uterine relaxation

4. One hour after receiving intravenous meperidine (Demerol) for pain during labor, a primigravid client delivers a full-term neonate with symptoms of respiratory depression. The nurse anticipates that the neonate will require the administration of which of the following?

a. Betamethasone (Celestone)b. Naltrexone (Trexan)c. Promethazine (Phenergan)d. Naloxone (Narcan)

5. A physician has ordered nalbuphine hcl (Nubain) 10 mg IV for a client in active labor. The pharmacy supplies a vial labeled as 50mg in a 5ml vial. Which of the following amounts would the nurse administer?

a. 0.5 ml

b. 1.0 ml

c. 1.5 ml

d. 2.0 ml

6. A child with asthma continues to have a heart rate of 160 bpm and a RR of 36 breaths/minute, the child appears restless and anxious. The child is given albuterol (Ventolin) via nebulizer. Which of the following would indicate that the nebulizer treatment has been effective?

a. pulse oximeter reading of 91%

b. nonproductive cough

c. expiratory wheezing

d. increase in peak expiratory flow rate

7. The nurse teaches the parents of a 2 y/o how to instill antibiotic ear drops. Which of the following statements about the direction to pull on the earlobe indicates that the child’s father has understood the teaching?

a. up and forward

b. up and backward

c. down and outward

d. down and backward

8. Which of the following techniques would be most appropriate to use when determining whether the parental teaching about how to administer ear drops correctly has been successful?

a. observing the parents instilling the ear drops in the child’s ear

b. listening to the parents as they describe the procedure

c. asking the parents to list the steps of the procedure

d. asking the parents whether they have read the handout on the procedure

9. When developing a teaching plan for the parents of a child who is receiving digoxin (Lanoxin), which of the following would be most important for the nurse to include?

a. telling the parents about the side effects

b. discussing why the child is receiving this medicine

c. explaining the difference between milligrams and micrograms

d. showing the mother the correct prescribed dosage

10. Which of the following would the nurse explain to the mother of a child receiving digoxin (Lanoxin) as the primary reason for giving this drug?

a. to relax the walls of the heart’s arteries

b. to improve the strength of the heartbeat

c. to prevent the irregularities in ventricular contractions

d. to decrease inflammation of the heart wall

11. Which of the following nursing measures would be carried out for a child who is receiving chemotherapy and allopurinol?

a. encouraging a high fluid intake

b. omitting carbonated fluids

c. giving foods that are high in potassium

d. limiting foods that are high in natural sugar

12. A child has an order to receive 250 ml of IV fluids daily for 4 hours. The nurse would set the infusion pump using microdrip tubing to run at which of the following flow rates?

a. 10 ml/hr

b. 25 ml/hr

c. 42 ml/hr

d. 63 ml/hr

13. A child is to receive IV fluids rate of 95 ml/hr. the tubing of the infusion delivers 10 drops/ml. at which of the following rates would the nurse infuse the solution?

a. 10 drops/minute

b. 14 drops/minute

c. 16 drops/minute

d. 20 drops/minute

14. Which of the following statement by an adolescent receiving gentamicin sulfate would the nurse interpret as indicating toxicity of the drug?

a. “ I’m feeling dizzy”

b. “ I have no appetite”

c. “ I urinate a lot now”

d. “ I haven’t moved my bowels in 3 days”

15. The mother of an infant who has an order for 40 mg of acetaminophen every 4 hours for pain states that she use the infant drops, which come in a concentration of 80 mg/ 0.8 ml. which of the following amounts would the nurse tell the mother to give the infant?

a. one dropperful

b. ½ dropperful

c. 0.78 ml using a 1 ml syringe

d. 1.5 ml, using a 3ml syringe

16. When administering AtS04 preoperatively to a client scheduled for lung surgery, the nurse should tell the client which of the following?

a. “ This medication will make you drowsy”

b. “ This medication will help you relax”

c. “ This medication will make your mouth feel dry”

d. “ This medication will reduce the risk of postoperative infection”

17. The nurse is preparing to administer digoxin (Lanoxin) 0.12 mg. scored 0.25 mg tablets are available. How many tablets should the nurse administer?

a. 0.5 tabb. 1 tabc. 1.5 tabd. 2 tabs

18. Which of the following medications would the nurse anticipate administering in the event of heparin overdose?

a. warfarin sodium

b. protamine sulfate

c. acetylsalicylic acid

d. atropine sulfate

19. Chloral hydrate 1000 mg has been ordered. It is available in syrup containing 0.5g/5 ml. how many milliliters should the nurse give?

a. 1.5 mlb. 3.0 mlc. 5.0 mld. 10.0 ml

20. The client is supposed to receive 500 ml of 5% dextrose on 0.45% NS with 20 mEq of potassium chloride over the next 6 hours. The infusion set administers 10 gtt/ml. to what flow rate should the nurse adjust the IV flow?

a. 14 gtt/min

b. 18 gtt/min

c. 21 gtt/min

d. 25 gtt/min

21. What is the primary purpose of administering aminophylline to a client with emphysema?

a. to relieve the spasms of the diaphragm

b. to relax smooth muscles in the bronchioles

c. to promote efficient pulmonary circulation

d. to stimulate the medullary respiratory center

22. Diuretic therapy with torsemide (Demadex) is started for a client with heart failure. When calling the client 2 days after the drug therapy is started, the nurse evaluates the torsemide as effective when the client says she has experienced which of the following outcomes?

a. she has an improved appetite and is eating better

b. she weighs 6 pound less than she did 2 years ago

c. she is less thirsty than she was before the drug therapy

d. she has clearer urine since starting the therapy

23. Which of the following techniques is correct for the nurse to use when inserting a rectal suppository for an adult client?

a. insert the suppository while the client bears down

b. place the client in a supine position

c. position the suppository along the rectal wall

d. insert the suppository 2 inches into the rectum

24. A client receiving digoxin (Lanoxin) for CHF undergoes cardiac catheterization to evaluate his condition further. The procedure reveals a cardiac output of 2.2 L/minute. How would the nurse evaluate this cardiac output?

a. high, because of the effects of digoxin

b. within normal limits, because of the effects of digoxin

c. within normal limits, but not adequate to support strenuous activity

d. low, requiring further medical intervention

25. Clients who are receiving total parenteral nutrition are at risk for development of which of the following complications?

a. hypostatic pneumonia

b. pulmonary hypotension

c. orthostatic hypotension

d. fluid imbalances

26. The client is receiving propantheline bromide to treat cholecystitis. The nurse would evaluate the client’s response to medication by observing for which of the following side effects?

a. urinary retention

b. Diarrhea

c. Hypertension

d. Diaphoresis

27. The nurse is preparing to start an IV infusion. Before inserting the needle into a vein, the nurse would apply a tourniquet to the client’s arm to accomplish which of the following?

a. distend the veins

b. stabilize the veins

c. immobilize the arm

d. occlude arterial circulation

28. The physician orders Ringer’s lactate solution to replace the fluid losses of a client. While the solution is infusing, the nurse should assess for which of the following symptoms that might indicate fluid overload is developing?

a. increasing abdominal girth

b. rapid, thready pulse

c. moist crackles on auscultation

d. increased urinary output

29. The client is to receive an IV infusion at 100ml/hour. The infusion set delivers 15gtt/ml. What is the flow rate of the infusion?

a. 10 gtt/min

b. 15 gtt/min

c. 21 gtt/min

d. 25 gtt/min

30. Procaine Penivillin G 600,000 units IM has been ordered. The nurse has available 1 ml prefilled syringe labeled 600,000 units/ml. how many ml should the nurse administer?

a. 0.25 ml

b. 0.50 ml

c. 1.0 ml

d. 2.5 ml

31. The nurse is administering eye drops to a client with glaucoma. Which of the following is a correct technique for instilling the eye drops? The eyes are placed:

a. in the lower conjunctival sac

b. near the opening of the lacrimal ducts

c. on the cornea

d. on the scleral surface

32. A client has an anaphylactic reaction to penicillin that results in respiratory distress. Which of the following medications would the nurse anticipates first?

a. Dopamine (Intropin)

b. Diphenhydramine (Benadryl)

c. Cimetidine (Tagamet)

d. Epinephrine

33. The nurse is preparing to give an IM injection. Which of the following sites has the least amount of blood vessels and major nerves located in the area?

a. Deltoid

b. Dorsogluteal

c. vastus lateralis

d. triceps

34. The nurse is planning to teach the client how to properly use a metered dose inhaler to treat asthma. Which of the following instructions should the nurse include in the teaching plan?

a. rinse the mouth after each use of a steroid inhaler

b. inhale quickly when administering the medication

c. inhale the medication and exhale through the nose

d. cough and deep breath before inhaling the medication

35. A client is receiving a transfusion of packed RBC. Which of the following actions should the nurse implement to safely administer the blood?

a. keep the blood refrigerated on the nursing unit until ready to administer

b. stay with the client during the first 15 minutes to detect signs of reaction

c. do not infuse any blood that has been hanging for more than 6 hours

d. administer the blood quickly if the client develops a fever to prevent wasting it

36. A client is receiving a blood transfusion when he begins to complain of difficulty of breathing. The nurse notes an elevated BP and a cough. Based on these signs, the nurse suspects which of the following complications?

a. anaphylactic reaction

b. circulatory overload

c. Sepsis

d. acute hemolytic reaction

37. The nurse administers an intradermal injection to a client. Proper technique has been used if the injection site demonstrates which of the following?

a. minimal leaking

b. no swelling

c. tissue pallor

d. evidence of a bleb

38. The sudden onset of which of the following signs or symptoms indicate a potentially serious complication for the client receiving an IV infusion?

a. noisy respirations

b. papillary constrictions

c. Halitosis

d. moist skin

39. The nurse is planning to initiate a blood transfusion. Which of the following solutions should the nurse select to prime the tubing when preparing to administer the blood?

a. Ringer’s lactate solution

b. 0.9% NSS

c. 5% dextrose in 0.45% NSS

d. 5% in dextrose water

40. Which of the following actions by the nurse will most likely ensure that the correct client receives a medication?

a. have the client state his/her name

b. call the client by name

c. learn to recognize the client

d. check the client’s identification armband

41. When instructing clients with allergic rhinitis about the use of nasal decongestants, it is important to emphasize that:

a. the condition will not benefit from environmental changes

b. continuous use of more than 3 days can result in worsening the symptoms

c. the condition requires treatment only during cold season

d. the condition is self-limited and should not return

42. The nurse is teaching a client with osteoporosis about taking Fosamax. The nurse emphasizes that the client is to take the medication:

a. at bedtime

b. with food

c. with a full glass of water and remain upright for 30 minutes

d. with a full glass of juice and then rest for 30 minutes

43. A client on the burn unit is receiving Sulfonamide cream (Silvadene) as a topical treatment for her burns. When reviewing the daily laboratory results, the nurse notices that the client’s WBC count has decreased. The nurse recognizes that:

a. it is normal to have immunosuppression

b. this is normal; an increased WBC would be a concern

c. this is abnormal; the physician needs to be alerted

d. the WBC should be observed over several days to look for a trend

44. Which of the following medication could predispose a woman to candidiasis?

a. Insulin

b. Lisinopril (Zestril)

c. Oral contraceptive pills

d. Phenytoin (Dilantin)

45. The nurse is preparing to administer an IM injection to a client and chooses the vastus lateralis muscle for the injection site. Into which part of the thigh would the nurse choose to correctly administer the medication?

a. middle third of the thigh

b. lower third of the thigh

c. upper third of the thigh

d. wherever the thigh is the largest

46. Which of the following factors would be the most important for the nurse to consider when determining the angle at which to insert the needle for a subcutaneous injection?

a. size of the syringe

b. tissue turgor

c. length of the needle

d. amount of subcutaneous tissue

47. A client with osteoarthritis is learning about his drug therapy. The nurse should instruct the client that which of the following drugs is considered the first line therapy for osteoarthritis?

a. Corticosteroids

b. NSAIDs

c. Acetaminophen

d. Narcotic analgesics

48. The nurse notes that a placebo has been ordered for use when a client requests pain medication. Which of the following statements is most accurate about the use of placebos in the client’s plan of care?

a. it is appropriate to substitute placebos when the client requests frequent doses of pain medication

b. placebos should be used when it is suspected that the client is addicted to pain medication

c. the use of placebos violates the client’s right to ethical care

d. Placebos may be used whenever the use believes the client is not really experiencing pain.

49. A client has been diagnosed with chlamydial infection. Which of the following antibiotics does the nurse anticipate will most likely be prescribed?

a. Probenecid (Benemid)

b. Ampicillin (Principen)

c. Doxycycline (Vibramycin)

d. Acyclovir (Zovirax)

50. A client is receiving intravenous heparin for treatment of DVT. Which of the following precautions should the nurse incorporate into the client’s plan of care as a result of receiving heparin intravenously?

a. establish a separate IV infusion line for administration of other prescribed drugs

b. check the client’s activated partial prothromboplastin time (aPTT) values daily to monitor for therapeutic anticoagulation

c. have Vitamin K injection available as an antidote to potential heparin overdose

d. protect the heparin infusion from light to prevent discoloration of the drug

51. The nurse wants to prepare a teaching plan for a client who is taking metoclopramide (Reglan). Which of the following is considered a side effect of the drug?

a. Constipation

b. urinary retention

c. Hypotension

d. extrapyramidal reactions

52. A client has been diagnosed with chronic gastritis caused by Helicobacter pylori. The nurse anticipates that which of the following drug categories will be most effective in treating gastritis?

a. Antacids

b. Antiemetics

c. antibiotic combinations

d. histamine2- receptor antagonists

53. A client who has been diagnosed with cirrhosis asks the nurse if there are any specific medications that he should avoid. Which one of the following medications should the nurse specifically tell the client not to take?

a. Acetaminophen (Tylenol)

b. Cimetidine (Tagamet)

c. Neomycin sulfate

d. Spironolactone (Aldactone)

54. Which of the following medications would the nurse expect to administer to a client experiencing an oculogyric crisis?

a. Chlorpromazine (Thorazine) 50 mg

b. Procyclidine (Kemadrin) 5 mg

c. Thioridazine (Mellaril) 100 mg

d. Benztropine (Congentin) 1 mg

55. Which of the following would the nurse include when teaching the family and a client prescribed benzotropine (Congentin) 1 mg PO twice daily, about the drug therapy?

a. the drug can be used with the OTC cough and cold preparations

b. the client should not discontinue taking the drug abruptly

c. antacids can be used freely when taking this drug

d. alcohol consumption with benzotropine therapy need not to be restricted

56. Which of the following would the nurse include in a teaching plan that addresses the side effects of antipsychotic medication?

a. information about all potential side effects

b. research data about rare side effects

c. side effects that can be seen or felt

d. percentages associated with each side effect

57. Clozapine (Clorazil) therapy has been initiated for a client with schizophrenia who has been unresponsiveness to other antipsychotics. The client states, “Why do I have to have a blood test every week?” which of the following responses by the nurse would be most appropriate?

a. “Weekly blood tests are necessary to determine safe dosage and to monitor the effect of the medication of the blood”

b. “Weekly blood tests are done so that you can receive another week’s supply of the medication.”

c. “Your physician will want to know how well you are progressing with the medication therapy”

d. “Everyone taking clozapine (Clozaril) has to go through the same procedure because it is required by the physician”

58. The mother of a 28 y/o who is taking clozapine (Clozapine) states, “Something is wrong. My son is drooling like a baby.” Which of the following responses by the nurse would be most helpful?

a. “ I wonder if he’s having an adverse reaction to the medicine”

b. “Excessive saliva is common with this drug; here’s a paper cup for him to spit up”

c. “ Don’t worry about it; this is only a minor inconvenience compared to its benefits”

d. “I’ve seen this happen to other client who are taking Clozapine”

59. A client taking Clozapine states, “ I think I’m getting the flu. I have a fever and feel weak.” Which of the following would the nurse do next?

a. tell the client to wait another day to see if other symptoms of the flu appear

b. advise the client to take some OTC meds for fluc. discuss the importance of maintaining an

adequate fluid intaked. report the client’s symptoms to the physician after

taking the client’s temperature

60. Assessment for which of the following side effects would be the priority for a client who is taking risperidone (Risperidal) 1 mg PO twice daily?

a. Insomnia

b. Headache

c. Anxiety

d. orthostatic hypotension

61. A client taking risperidone (Risperidal) 2 mg PO twice daily informs the clinic nurse that she will be getting married in 3 months to another client she met at the outpatient clinic. During the client interview, which of the following would be an area of priority concern?

a. her fiancé’s medication compliance

b. money management

c. plan of pregnancy

d. living arrangement

62. A client whose symptoms of schizophrenia are under control with olanzapine (Zyprexia), and who is functioning at home and in her part time employment, states that she is very concerned about her 20 pounds weight gain since she started taking the medication 6 months ago. Which of the following is the most appropriate response by the nurse?

a. suggest that the client talk with her physician about changing to another psychotic

b. advise the client to decrease her dosage by one halfc. tell the client not to worry because she should stop gaining

weightd. discuss nutrition, daily diet, and exercise with the client

63. A 67 y/o client will be discharge to home with imipramine (Tofranil). Which of the following would be most important to include when instructing the client and spouse about the medication?

a. eat a high fiber diet

b. wear sunglasses outdoors

c. avoid ingestion of alcohol

d. urinate as soon as the urge is felt

64. The nurse is teaching a client and family about the phenelzine (Nardil). Which of the

following foods would the nurse urge the client to avoid?

a. Eggs

b. Chicken

c. American cheese

d. Sour cream

65. When preparing the drug teaching plan for a client who is taking phenelzine (Nardil), which of the following signs and symptoms would the nurse stress as most important to report to the physician immediately?

a. urinary hesitancy

b. Palpitations

c. dry mouth

d. blurred vision