Showing posts with label Pharmacology Practice Test. Show all posts
Showing posts with label Pharmacology Practice Test. Show all posts

NCLEX Pharmacology Practice Questions (96-100)

Welcome to NCLEX Pharmacology Practice Questions. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. 

Good Luck.


96. A client with schizophrenia tells the nurse, "I stopped taking my chlorpromazine (Thorazine) because of the way it made me feel." Which side effect is the nurse likely to note during further assessment of the client's complaint?

a) drowsiness
b) nervousness
c) hard tremors
d) increased urination

97. A nurse is caring for a client diagnosed with a skin infection who is receiving tobramycin sulfate (Nebcin) intravenously every 8 hours. Which of the following would indicate to the nurse that the client is experiencing an adverse reaction related to the medication?

a) a total bilirubin of 0.5 mg/dL
b) a sedimentation rate of 15 mm/hr
c) a blood urea nitrogen (BUN) of 30 mg/dL
d) a white blood cell count (WBC) of 6000 cells/mm3

98. A client has been taking an anti-hypertensive for approximately 2 months. A home care nurse monitoring  the effects of therapy determines that drug tolerance has developed if which of the following are noted in the client?

a) decrease in weight
b) output greater than intake
c) decrease in blood pressure
d) gradual rise in blood pressure

99. A nurse has an order to administer hydroxyzine (Vistaril) to a client by the intramuscular route. Before administering the medication, the nurse tells the client that:

a)  excessive salivation is a side effect
b) there will be some pain at the injection site
c) there will be relief from nausea within 5 minutes
d) the client will have increased alertness for about 2 hours

100. A nurse is preparing to administering diazepam (Valium) by the intravenous (IV) route to a client who is having a seizure. The nurse plans to:

a) administer the prescribed dose over at least 60 minutes
b) dilute the prescribed dose in 50 ml of 5% dextrose in water
c) administer the prescribed by IV push directly into the vein
d) mix the prescribed dose into the existing IV of 5% dextrose in normal saline






NCLEX Pharmacology Practice Questions
Answers and Rationale

96) A
- Side effects of chlorpromazine can include hypotension, dizziness and fainting especially with parenteral use, drowsiness, blurred vision, dry mouth, lethargy, constipation or diarrhea, nasal congestion, peripheral edema, and urinary retention. Options B, C, and D are not side effects of chlorpromazine.

97) C
- Adverse reactions or toxic effects of tobramycin sulfate include nephrotoxicity as evidenced by an increased BUN and serum creatinine; irreversible ototoxicity as evidenced by tinnitus, dizziness, ringing or roaring in the ears, and reduced hearing; and neurotoxicity as evidenced by headaches, dizziness, lethargy, tremors, and visual disturbances. A normal WBC is 4500 to 11,000 cells/mm3. The normal sedimentation rate is 0 to 30 mm/hour. The normal total bilirubin level is less than 1.5 mg/dL. The normal BUN is 5 to 20 mg/dL.

98) D
- Drug tolerance can develop in a client taking an antihypertensive, which is evident by rising blood pressure levels. The physician should be notified, who may then increase the medication dosage or add a diuretic to the medication regimen. The client is also at risk of developing fluid retention, which would be manifested as dependent edema, intake greater than output, and an increase in weight. This would also warrant adding a diuretic to the course of therapy.

99) B
- Hydroxyzine is an antiemetic and sedative/hypnotic that may be used in conjunction with opioid analgesics for added effect. The injection can be extremely painful. Medications administered by the intramuscular route generally take 20 to 30 minutes to become effective. Hydroxyzine causes dry mouth and drowsiness as side effects.

100) C
- Intravenous diazepam is given by IV push directly into a large vein (reduces the risk of thrombophlebitis), at a rate no greater than 1 mg per minute. It should not be mixed with other medications or solutions and can be diluted only with normal saline.


After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

NCLEX Pharmacology Practice Questions (1-5)


Or proceed to the next set of questions:

NCLEX Pharmacology Practice Questions (101-105)

NCLEX Pharmacology Practice Questions (91-95)

Welcome to NCLEX Pharmacology Practice Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :

Complete NCLEX Study Materials

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


91. A client with myasthenia gravis is admitted to the hospital, and the nursing history reveals that the client is taking pyridostigmine (Mestinon). The nurse assesses the client for side effects of the medication and asks the client about the presence of:

a) mouth ulcers
b) muscle cramps
c) feelings of depression
d) unexplained weight gain

92. A nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris who is receiving sotalol (Betapace) 80 mg orally daily. Which assessment finding indicates that the client is experiencing a side effect of the medication?

a) dry mouth
b) palpitations
c) diaphoresis
d) difficulty swallowing

93. A nurse is caring for a client who had an allogenic liver transplant and is receiving tacrolimus (Prograf) daily. Which finding indicates to the nurse that the client is experiencing an adverse reaction to the medication?

a) photophobia
b) hypotension
c) profuse sweating
d) decrease in urine output

94. A nurse is caring for a client who is receiving cyclosporine (Gengraf). Which of the following indicates to the nurse that the client is experiencing an adverse reaction to the medication?

a) acne
b) sweating
c) joint pain
d) hyperkalemia

95. A nurse is caring for a client with hypertension receiving torsemide (Demadex) 5 mg orally daily. Which of the following would indicate to the nurse that the client might be experiencing an adverse reaction related to the medication?

a) a chloride level of 98 mEq/L
b) a sodium level of 135 mEq?L
c) a potassium level of 3.1 mEq/L
d) a blood urea nitrogen (BUN) of 15 mg/dL






NCLEX Pharmacology Practice Questions
Answers and Rationale

91) B
- Mestinon is an acetylcholinesterase inhibitor. Muscle cramps and small muscle contractions are side effects and occur as a result of overstimulation of neuromuscular receptors. Options A, C, and D are not associated with this medication.

92) B
-  Sotalol is a beta-adrenergic blocking agent. Side effects include bradycardia, palpitations, an irregular heartbeat, difficulty breathing, signs of congestive heart failure, and cold hands and feet. Gastrointestinal disturbances, anxiety and nervousness, and unusual tiredness and weakness can also occur. Options A, C, and D are not side effects of this medication.

93) D
- Tacrolimus is an immunosuppressant medication used in the prophylaxis of organ rejection in clients receiving allogenic liver transplants. Frequent side effects include headache, tremor, insomnia, paresthesia, diarrhea, nausea, constipation, vomiting, abdominal pain, and hypertension. Adverse reactions and toxic effects include nephrotoxicity and pleural effusion. Nephrotoxicity is characterized by an increasing serum creatinine level and a decrease in urine output.

94) D
- Cyclosporine is an immunosuppressant medication used in the prophylaxis of organ rejection. Adverse effects include nephrotoxicity, infection, hypertension, tremor, and hirsutism. Additionally, neurotoxicity, gastrointestinal effects, hyperkalemia, and hyperglycemia can occur. Options A, B, and C are not associated with this medication.

95) C
- Torsemide (Demadex) is a loop diuretic. The medication can produce acute, profound water loss, volume and electrolyte depletion, dehydration, decreased blood volume, and circulatory collapse. Option C is the only option that indicates an electrolyte depletion because the normal potassium level is 3.5 to 5.1 mEq/L. The normal sodium level is 135 to 145 mEq/L. The normal chloride level is 98 to 107 mEq/L. The normal blood BUN is 5 to 20 mg/dL.


After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

NCLEX Pharmacology Practice Questions (1-5)


Or proceed to the next set of questions:

NCLEX Pharmacology Practice Questions (96-100)

NCLEX Pharmacology Questions (86-90)

Welcome to NCLEX Pharmacology Questions . Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :

Complete NCLEX Study Materials

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


86. A client with myasthenia gravis is admitted to the hospital, and the nursing history reveals that the client is taking pyridostigmine (Mestinon). The nurse assesses the client for side effects of the medication and asks the client about the presence of:

a) mouth ulcers
b) muscle cramps
c) feelings of depression
d) unexplained weight gain

87. A nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris who is receiving sotalol (Betapace) 80 mg orally daily. Which assessment finding indicates that the client is experiencing a side effect of the medication?

a) dry mouth
b) palpitations
c) diaphoresis
d) difficulty swallowing

88. A nurse is caring for a client who had an allogenic liver transplant and is receiving tacrolimus (Prograf) daily. Which finding indicates to the nurse that the client is experiencing an adverse reaction to the medication?

a) photophobia
b) hypotension
c) profuse sweating
d) decrease in urine output

89. A nurse is caring for a client who is receiving cyclosporine (Gengraf). Which of the following indicates to the nurse that the client is experiencing an adverse reaction to the medication?

a) acne
b) sweating
c) joint pain
d) hyperkalemia

90. A nurse is caring for a client with hypertension receiving torsemide (Demadex) 5 mg orally daily. Which of the following would indicate to the nurse that the client might be experiencing an adverse reaction related to the medication?

a) a chloride level of 98mEq/L
b) a sodium level of 135 mEq/L
c) a potassium level of 3.1 mEq/L
d) a blood urea nitrogen (BUN) of 15 mg/dL






NCLEX Pharmacology Questions
Answers and Rationale

86) B
- Mestinon is an acetylcholinesterase inhibitor. Muscle cramps and small muscle contractions are side effects and occur as a result of overstimulation of neuromuscular receptors. Options A, C, and D are not associated with this medication.

87) B
- Sotalol is a beta-adrenergic blocking agent. Side effects include bradycardia, palpitations, an irregular heartbeat, difficulty breathing, signs of congestive heart failure, and cold hands and feet. Gastrointestinal disturbances, anxiety and nervousness, and unusual tiredness and weakness can also occur. Options A, C, and D are not side effects of this medication.

88) D
- Tacrolimus is an immunosuppressant medication used in the prophylaxis of organ rejection in clients receiving allogenic liver transplants. Frequent side effects include headache, tremor, insomnia, paresthesia, diarrhea, nausea, constipation, vomiting, abdominal pain, and hypertension. Adverse reactions and toxic effects include nephrotoxicity and pleural effusion. Nephrotoxicity is characterized by an increasing serum creatinine level and a decrease in urine output.

89) D
- Cyclosporine is an immunosuppressant medication used in the prophylaxis of organ rejection. Adverse effects include nephrotoxicity, infection, hypertension, tremor, and hirsutism. Additionally, neurotoxicity, gastrointestinal effects, hyperkalemia, and hyperglycemia can occur. Options A, B, and C are not associated with this medication.

90) C
- Torsemide (Demadex) is a loop diuretic. The medication can produce acute, profound water loss, volume and electrolyte depletion, dehydration, decreased blood volume, and circulatory collapse. Option 3 is the only option that indicates an electrolyte depletion because the normal potassium level is 3.5 to 5.1 mEq/L. The normal sodium level is 135 to 145 mEq/L. The normal chloride level is 98 to 107 mEq/L. The normal blood BUN is 5 to 20 mg/dL.



After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

NCLEX Pharmacology Questions (1-5)



Or proceed to the next set of questions:

NCLEX Pharmacology Questions (91-95)

NCLEX Pharmacology Questions (81-85)

Welcome to NCLEX Pharmacology Questions . Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :

Complete NCLEX Study Materials

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


81. Sodium hypochlorite (Dakin's solution) is prescribed for a client with a leg wound that is draining purulent material and the home health nurse teaches a family member how to perform wound treatments. Which statement, if made by the family member, indicates a need for further teaching?

a) a fresh solution needs to be prepared frequently
b) the solution should not come in contact with normal skin tissue
c) I should rinse the solution off immediately following the irrigation
d) I will soak a sterile dressing with solution and pack it into the wound

82. Dextranomer (Debrisan) is prescribed for a client with a pressure ulcer. The nursing instructor asks the nursing student preparing to perform the treatment about the medication and procedure. Which statement, if made by the student, indicates a need for further research?

NCLEX Pharmacology Questions (76-80)





NCLEX Pharmacology Questions

76. The home care nurse provides medication instructions to an older hypertensive client who is taking lisinopril (Prinivil), 20 mg orally daily. Which statement, if made by the client, indicates that further teaching is necessary?

a) I can skip a dose once a week
b) I need to change my position slowly
c) I take the pill after breakfast each day
d) If I get bad headache, I should call my doctor immediately

77. The nurse is providing medication instructions to an older client who is taking digoxin (Lanoxin) daily. Th nurse notes that which age-related body changes could place the client at risk for digoxin toxicity?

a) decreased muscle strength and loss of bone density
b) decreased cough efficiency and decreased vital capacity
c) decrease salivation and decreased gastrointestinal motility
d) decreased lean body mass and decreased glomerular filtration rate

Online Nursing Practice Test about Pharmacology (71-75)





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71. A nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which of the following is part of the plan for preparation and administration of the potassium?

a) obtaining a controlled IV infusion pump
b) monitoring urine output during administration
c) diluting in appropriate amount of normal saline
d) preparing the medication for bolus administration  

72. A client is brought to the emergency room stating that he has accidentally been taking two times his prescribed dose of warfarin (Coumadin) for the past week. After noting that the client has no evidence of obvious bleeding, the nurse plans to do which of the following next?

a) prepares to administer the antidote
b) draws a sample for type crossmatch and transfuse the client
c) draws a sample for an activated partial thromboplastin (aPTT)
d) draws a sample for prothrombin (PT) and international normalized ration (INR) level

73. Methylergonovine (Methergine) is prescribed for a woman to treat postpartum hemorrhage. Before administration of methylergonovine, the priority nursing assessment is to check the:

a) uterine tone
b) blood pressure
c) amount of lochia
d) deep tendon reflexes

74. A nurse is preparing to administer beractant (survanta) to a premature infant who has respiratory distress syndrome. The nurse plans to administer the medication by which of the following routes?

a) intradermal
b) intratracheal
c) subcutaneous
d) intramuscular

75. A nurse is caring for a client who is receiving oxytocin (Pitocin) to induce labor. The nurse discontinuous the oxytocin infusion if which of the following is noted on assessment of the client?

a) fatigue
b) drowsiness
c) uterine hyperstimulation
d) early decelerations of the fetal heart rate




ANSWERS AND RATIONALE

71) D
- potassium chloride administered intravenously must always be diluted in IV fluid and infused via a pump or controller. The usual concentration of IV potassium chloride is 20 to 40 mEq/L. Potassium chloride is never given by bolus (IV push). Giving potassium chloride by IV push can result in cardiac arrest. Dilution in normal saline is recommended, but dextrose solution is avoided because this type of solution increases intracellular potassium shifting. The IV bag containing the potassium chloride is always gently agitated before hanging. The IV site is monitored closely because potassium chloride is irritating to the veins and the risk of phlebitis exists.

72) D
- the next action is to draw a sample for PT and INR level to determine the client's anticoagulation status and risk for bleeding. These results will provide information as to how to best treat this client if an antidote (vitamin K) or blood transfusion is needed. The aPTT monitors the effects of heparin therapy.

73) B
- methylergonovine, an ergot alkaloid, is an agent that is used to prevent or control postpartum hemorrhage by contracting the uterus. Methylergonovine causes continuous uterine contractions and may elevate blood pressure. A priority assessment before the administration of the medication is to check the blood pressure. The physician should be notified if hypertension is present. Although options A, C, and D may be components of postpartum assessment, option B, blood pressure, is related specifically to the administration of this medication.

74) B
- respiratory distress is common in a premature neonates and may be due to lung immaturity as a result of surfactant deficiency. The mainstay of treatment is the administration of exogenous surfactant, which is administered by the intratracheal route. Option A, C, and D are not routes of administration for this medication.

75) C
- oxytocin stimulates uterine contractions and is a common pharmacological method to induce labor. An adverse reaction associated with administration of this medication is hyperstimulation of uterine contractions. Therefore, oxytocin infusion must be stopped when any signs of uterine hyperstimulation are present. Drowsiness and fatigue may be caused by the labor experience. Early decelerations of the fetal heart rate are reassuring sign and do not indicate fetal distress.



Related Topics:

Online Nursing Practice Test about Pharmacology (66-70)





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66. The patient is receiving heparin. What should the nurse keep readily available?

a) aquamephyton
b) coumadin
c) ASA
d) protamine sulfate

67. Which of the following drugs more likely will be prescribed for a client with Zollinger-Ellison syndrome?

a) tapazole
b) propylthiouracil
c) omeprazole
d) hydrochlorothiazide

68. The client's serum albumin level is 2 mg/dL. Which of the following drugs does the nurse anticipate to be ordered by the physician?

a) hetastarch
b) ciprofloxacin
c) lisinopril (zestril)
d) furosemide (lasix)

69. Which of the following indicates effectiveness of levodopa in a client with Parkinson's disease?

a) relief of tremors and rigidity
b) improved emotional state
c) improve of memory
d) return of sensation

70. The client is receiving Retrovir. Which of the following are potential side effects of the drugs? Select all that apply

a) tingling sensation
b) elevated BUN, serum creatinine
c) hyperglycemia
d) elevated liver enzymes
e) hypertension



ANSWERS AND RATIONALE

66) D
- protamine sulfate is the antidote of heparin, if bleeding occurs.

67) C
- Zollinger-Ellison syndrome is characterized by multiple areas of ulcers in the gastrointestinal tract. Omeprazole reduces gastric acid production and help relieve signs and symptoms experienced by the patient.

68) A
- the normal serum albumin level is 3.5 to 5 mg/dl. If the level is low, the client needs plasma expander like hetastarch.

69) A
- levodopa relieves tremors and rigidity in clients with Parkinson's disease.

70) A, B, D
- these are potential side effects of Retrovir, an antiviral medication.


Related Topics:

Online Nursing Practice Test about Pharmacology (61-65)

61. The nurse will administer drugs to several patients. Which of the following drugs should she administer first?

a) hydralazine for a client with PIH
b) antibiotic for ruptured abscess
c) insulin for a client with high blood glucose
d) diuretic for the client with congestive heart failure

62. When administering Synthroid (Levothyroxine), which of the following considerations should be observed by the nurse?

a) assess pulse rate prior to administration
b) administer the medication on full stomach
c) advise client to increase fluid intake
d) monitor intake and output

63. Which of the following is an important nursing consideration when administering Garamycin?

a) monitor blood pressure
b) monitor intake and output
c) monitor body temperature
d) monitor pulse rate

64. When a client is on Chlorothiazide therapy, which of the following should be included in the health teachings to the client?

a) include fruits and green leafy vegetables in the diet
b) include milk and cheese in the diet
c) include meat in the diet
d) include beans and rice in the diet

65. The nurse will administer an IV fluid of 1,000 mls for 10 hours. The IV set has a drop factor of 10 gtts/ml. How many gtts/min should the nurse regulate the IV fluid.



ANSWERS AND RATIONALE

61) D
- the client with CHF experiences increased cardiac workload and dyspnea. Therefore, diuretic needs to be given first among the aforementioned medications. Priority: ABC.

62) A
- thyroid preparation like Synthroid may cause tachycardia. Therefore the nurse should check the client's pulse rate prior to administration of this drug.

63) B
- garamycin is nephrotoxic. Kidney function should be monitored like measuring fluid intake and output when administering this drug.

64) A
- chlorothiazide is a potassium-wasting diuretic. Potassium-rich foods like fruits and green leafy vegetables should be included in the diet to prevent hypokalemia.

65) 17 gtts/min

gtts/min = vol in cc x gtt factor/no. of hours x 60 mins

1,000 x 10/10 x 60 = 10,000/600

= 17 gtts/min


Related Topics:

Online Nursing Practice Test about Pharmacology (56-60)





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56. The client receives thyroid replacement therapy and notes inadequacy when which of the following findings occur?

a) prolonged QT interval
b) tachycardia
c) nervousness
d) hypothermia

57. A patient is undergoing testing to confirm diagnosis of myasthenia gravis. The nurse explains that the diagnosis is confirmed when muscle function improves after the patient receives an IV injection of a medication. What is this drug administered to the patient during the test?

58. The nurse is caring for a 10-year old client newly diagnosed with tonic-clonic seizure disorder. What instructions do you give the mother about phenytoin?

a) monitor the child for skin rash
b) maintain adequate amounts of fluids
c) the child will be frequently having blood works done
d) maintain good oral hygiene, brushing and flossing
e) report to the physician any problems with walking, coordination, slurred speech, and nausea

59. Which of the following drugs will be administered first in the patient with bronchial asthma?

a) corticosteroid
b) bronchodilator
c) antihistamine
d) mucolytic

60. Which of the following drugs is administered first, in a client with asthma?

a) robitussin DM
b) benadryl (diphenhydramine)
c) beclomethasone (vanceril)
d) theophylline (theo-dur)



ANSWERS AND RATIONALE

56) D
- hypothermia indicates that the client is still experiencing hypothyroidism. Therefore, the thyroid replacement therapy is inadequate.

57) Tensilon
- tensilon (edrophonium) is a short-acting cholinergic. Positive tensilon test is characterized by transitory improvement of the client's signs and symptoms. Then after a few minutes, these signs and symptoms recur.

58) A, B, C, E
- these are health instructions to be given during phenytoin therapy. Dilantin may cause skin rash, constipation, gingival hyperplasia (bleeding, tenderness, swelling of gums), bone marrow depression (pancytopenia), ataxia, nystagmus, double vision, drowsiness. Dental flossing should be avoided because bleeding may occur due to gum hyperplasia and blood dyscrasia.

59) B
- bronchodilator should be administered first in a patient with bronchial asthma so that the other medications can be inhaled into the bronchial tree more adequately.

60) D
- theophylline is a bronchodilator. It is the first drug to be administered in asthma to facilitate breathing and better absorption of the drugs.


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Online Nursing Practice Test about Pharmacology (51-55)

51. A medication is ordered to be given, 1250 mg. BID. Available stock is 10 gram in 50 ml. How many ml. will be given per dose?

52. The client with schizophrenia has been prescribed with Thorazine (Chlorpromazine) 25 mg QID. He experiences protrusion and rolling of tongue, involuntary movements of the body and extremities, sucking and smacking movements of the lips. These signs and symptoms indicate which of the following adverse reactions to the drug?

a) pseudoparkinsonism
b) akathisia
c) acute dystonia
d) tardive dyskinesia

53. You will administer an IV solution of D5LR 3L for fluid replacement on a patient with mild dehydration for 24 hours. What is the infusion rate in drops per minute? Answer in whole numbers

54. The patient with supraventricular tachycardia has been treated with digoxin. What should be considered when giving the medication? Select all that apply

a) monitor digoxin blood levels
b) check and count apical pulse for a whole minute
c) recognize symptoms of hypokalemia
d) withhold medication when client complains of visual disturbances and refer to opthalmologist
e) place digoxin under the tongue
f) give digoxin bolus dose as ordered

55. The client is prescribed with Lisinopril (Zestril) for treatment of hypertension. She asks you about the possible side effects of the medication. Which of the following are possible side effects of the drug? Select all that apply

a) dizziness
b) headache
c) constipation
d) hyperglycemia
e) hypotension
f) impotence



ANSWERS AND RATIONALE

51) 6.25 ml

D/S x dilution = quantity of the drug

10 g = 10g x 1,000 mg/gm = 10,000 mg

1,250 mg/10,000 mg x 50 = 6.25 ml


52) D
- these signs and symptoms characterize tardive dyskinesia.
Pseudoparkinsonism is characterized by rigidity
Akathisia is motor restlessness
Acute dystonia is characterized by muscle spasms and contractions

53) 31 gtts/min

gtts/min = vol. in cc x gtt factor/no. of hours x 60 min

= 3,000 x 15/24 hrs x 60 min
= 450,000/1,440
= 31 gtts/min

54) A, B, C, F
- these are nursing considerations when administering digoxin. The therapeutic serum level of digoxin is 0.5 to 2.0 mg/ml. Above this level results to digoxin toxicity.
Digoxin decreases heart rate and increases force of cardiac contractility. Hypokalemia increases risk of digitalis toxicity.
Visual disturbances indicate digitalis toxicity. Hold the medication and notify physician.
Digoxin is not given sublingually. Bolus dose of digoxin is administered as ordered to produce rapid effect of the drug.

55) A, B, E
- these are possible side effects of Lisinopril, an angiotensin-converting enzyme inhibitor.


Related Topics:

Online Nursing Practice Test about Pharmacology (46-50)

46. The client is taking Sudafed. Which herbal drug should not be taken by the client?

a) valerian
b) feverfew
c) black cohosh
d) billberry

47. The client is taking neupogen. Which of the following is the desired effect of the drug?

a) increased in plasma
b) increased in platelet
c) increase in RBC'S
d) increase in WBC

48. The client is on Coumadin therapy. The prothrombin time (PT) is 32 secs. Which of the following is the most appropriate action by the nurse?

a) withhold the drug
b) continue giving the drug
c) report the result to the physician
d) increase the dose

49. A woman in preterm labor will receive Betamethasone. What is the purpose of this medication?

a) to delay the delivery of the fetus
b) to promote fetal lung maturity
c) to relax the uterus
d) to shorten second stage of labor

50. Which of the following signs and symptoms indicates early digitalis toxicity?

a) the client complains of dryness of mouth
b) the client complains of watery stools
c) the client complains of blurring of visions
d) the client complains of numbness of fingers and toes




ANSWERS AND RATIONALE

46) A
- valerian is a sedative-hypnotic. It may cause drowsiness when taken in conjunction with decongestant like sudafed.

47) D
- neupogen is administered to increase WBC levels. Epogen is administered to increase RBC

48) B
- therapeutic effect of coumadin is: Normal value of PT (control) x 1.5-2 (11-16 secs x 2 = 22-32 secs). Therefore continue giving Coumadin, because PT of 32 secs is within the therapeutic range.

49) B
- betamethasone promotes fetal lung maturity. It is indicated if preterm labor is inevitable. This will give chance for the fetus to survive.

50) B
- diarrhea is an early manifestation of digitalis toxicity. Other manifestations of digitalis toxicity are as follows: nausea and vomiting, anorexia, bradycardia, dysrhythmias, visual disturbances and antiandronergic effects among males (gynecomastia, decreased libido, and impotence). Blurring of vision is a late manifestation of digitalis toxicity.


Related Topics:

Online Nursing Practice Test about Pharmacology (41-45)

41. The client is receiving Spironolactone (Aldactone). Which of the following diets is recommended for the client?

a) high-potassium diet
b) high-protein diet
c) low-potassium diet
d) low protein diet

42. The client is receiving Gentamycin sulfate (Garamycin). Which of the following are side effects of the drug? Select all that apply.

a) photosensitivity
b) elevated BUN
c) elevated serum creatinine
d) hearing loss
e) increased urine output
f) nausea and vomiting

43. The client is receiving amphogel (AL-OH). Which of the following are side effects of the drug? Select all that apply.

a) constipation
b) hypophosphatemia
c) hyperkalemia
d) hypercalcemia
e) diarrhea
f) hypermagnesemia

44. The client is receiving Pepcid (Famotidine). Which of the following should be included when giving health teachings to the client?

a) take the medication with meals
b) avoid taking aspirin
c) take the medication with milk
d) take the medication before meals

45. The client is in digitalis therapy. What question should the nurse ask to know if the client is experiencing digitalis toxicity?

a) do you feel dizzy?
b) do you experience lack of appetite to eat?
c) do you have constipation?
d) do you experience tightening of your ring?



ANSWERS AND RATIONALE

41) C
- spironolactone is a potassium-sparing diueretic. It may cause hyperkalemia so; the diet of the client should be low-potassium diet.

42) A, B, C, D, F
- gentamycin causes photosensitivity, nephrotoxicity, and ototoxicity. It also causes G.I. manifestations.

43) A, B, D
- amphogel is a phosphate binder. It causes constipation. As it binds with phosphate, phosphate is excreted via the GI tract. As phosphates goes down, levels of calcium will elevate: hypophosphatemia -> hypercalcemia.

44) B
- pepcid is indicated in peptic ulcer disease. Aspirin causes gastric irritation; therefore it should not be taken by the client.

45) B
- anorexia is an early sign of digitalis toxicity. Other signs and symptoms of digitalis toxicity are as follows: bradycardia, nausea and vomiting, dysrhythmias, blurred vision, green/yellow vision, halos/rainbows around lights, antiandrogenic effects like gynecomastia, decreased libido, and impotence.


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Online Nursing Practice Test about Pharmacology (36-40)





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36. The client is on coumadin therapy. Which of the following is inappropriate action by the nurse?

a) monitor prothrombin time
b) observe for signs and symptoms of bleeding
c) provide vitamin K-rich foods
d) have aquamephyton readily available

37. The physician order is acetaminophen (tylenol) gr xv, P.O., PRN. Available stock is tylenol 325 mg. tablet. How many tablets should be given?

38. The physician ordered gentamycin (garamycin) 50 mg IM. Available stock is gentamycin 80mg/2ml in a vial. How many ml. should be administered to client?

39. Which of the following indicates effectiveness of lactulose in a client with hepatic encephalopathy?

a) dehydration is resolved
b) level of consciousness (LOC) has improved
c) 4 watery stools in 24 hours
d) jaundice is diminished

40. Which of the following is not a side effect of dilaudid?

a) respiratory depression
b) urinary retention
c) hypertension
d) constipation



ANSWERS AND RATIONALE

31) C
- vitamin K antagonizes effect of coumadin. Therefore, the client should avoid vitamin K rich foods.

32) 3 tablets

gr 1 = 60 mg gr 15 x 60 mg/gr = 900 mg

D/S = Q of drug
900mg/325mg = 3 tablets


33) 1.25 ml

D/S = Q of drug
50mg/80mg x 2 ml = 1.25 ml

34) B
- lactulose acidifies the colon and prevents formation of alkaline ammonia. Therefore, it manages hepatic encephalopathy is resolved, there will be improvement of LOC.

35) C
- dilaudid is a narcotic analgesic. It causes hypotension not hypertension.


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Online Nursing Practice Test about Pharmacology (31-35)

31. 60-year old man is receiving Tagamet/IV. After 30 minutes of infusion, he complains of headache and dizziness. Which of the following actions should the nurse take first?

a) stop infusion
b) call the physician
c) take vital signs
d) elevate the head of bed

32. The client is receiving Gentamycin sulfate (garamycin), an amoniglycoside. Which of the following laboratory tests should the nurse monitor?

a) BUN, serum creatinine
b) SGOT, SGPT
c) serum glucose levels
d) complete blood count

33. Which of the following statements by the client indicates effectiveness of benzodiazepines?

a) my appetite to eat has greatly improved
b) I am less confused than before
c) I can remember things better now
d) I am now sleeping more than I used to

34. Which of the following assessment indicates the need for Dilantin (phenytoin) administration after dialysis?

a) headache, nausea, vomiting
b) hypertension, headache, restlessness
c) nausea, vomiting, restlessness
d) dizziness, headache, restlessness

35. The client is on Mestinon therapy. Which of the following signs and symptoms when experienced by the client need to be reported to the physician? Select all that apply

a) weakness
b) diarrhea
c) reduced tremors
d) increased muscle strength
e) nausea and vomiting
f) abdominal cramps
g) headache, dizziness



ANSWERS AND RATIONALE

31) A
- these are sins of adverse reaction to the medication. Therefore the nurse should stop the infusion.

32) A
- gentamycin is an aminoglycoside. The most common side effect of gentamycin is nephrotoxicity. BUN and serum creatinine are indicators of renal function.

33) D
- benzodiazepines (e.g. diazepam, alprozalam, and lorazepam) are sedative hypnotics, so they can promote sleep.

34) C
- twitching indicates seizure. Therefore dilantin, an anticonvulsant is indicated.

35) A, B, D, E, F
- these are signs and symptoms of cholinergic crisis and should be reported. Mestinon is a cholinergic medication, indicated in clients with myasthenia gravis. It is used to relieve muscle weakness.


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Online Nursing Practice Test about Pharmacology (26-30)





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26. Which of the following signs and symptoms indicates toxicity of gentamycin sulfate (garamycin)?

a) nausea and vomiting
b) hypotension
c) numbness of fingers and toes
d) ringing in the ears

27. The client has history of allergy to sulfonamides and penicillin. Which of the following drugs may safely be given to the client?

a) ampicillin
b) cloxacillin
c) ciprofloxacin
d) co-trimoxazole

28. The client is receiving Floricef. Which of the following types of diet should the nurse advise the client to have?

a) low sodium, high potassium, high protein
b) low sodium, low potassium, low protein
c) high sodium, high potassium, high protein
d) high sodium, high potassium, low protein

29. The client is receiving Questran. Which of the following should be included in the client teaching?

a) limit fluid intake
b) take fat-soluble vitamins
c) include potassium-rich foods in the diet
d) provide low-fiber diet

30. Which of the following health teachings should be included by the nurse for a client on prolonged Dilantin treatment?

a) wear long-sleeved clothing
b) use soft-bristled toothbrush
c) notify physician if urine becomes reddish brown
d) take the medication one hour before meals


ANSWERS AND RATIONALE

26) D
- gentamycin sulfate is an aminoglycoside. Common side effects are ototoxicity, nephrotoxicity and hepatotoxicity. Ringing in the ears indicates ototoxicity.

27) C
- ciprofloxacin is a quinolone. It can safely be given if a client has allergy to sulfonamides and penicillin. Ampicillin and cloxacillin are penicillins. Co-trimoxazole is a sulfonamide. If a client has allergy to penicillin, more likely he also, has allergy to cephalosphorin.

28) A
- floricef is a steroid. It causes retention of sodium ion, excretion of potassium ion and protein breakdown. The diet should be low sodium, high in potassium, high protein.

29) B
- questran is antihyperlipidemic. It may inhibit absorption of fat-soluble vitamins, or may enhance excretion of fat-soluble vitamins. Therefore, the client needs to take fat-soluble vitamins.

30) B
- dilantin may cause gum hyperplasia. Prevention of this adverse effect includes good oral care, massaging the gums, and using soft-bristled toothbrush.


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Online Nursing Practice Test about Pharmacology (21-25)





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21. Which of the following assessment findings indicate that propylthiouracil (PTU) is effective in the treatment of grave's disease?

a) the exopthalmos is decreased
b) the weight decreased
c) the edema decreased
d) the pulse rate decreased

22. What medication does the nurse expect to be prescribed for a client with adrenal insufficiency?

a) epinephrine
b) hydrocortisone
c) cyclophosphamide
d) amphogel

23. A patient is on coumadin therapy. Which statement when made by the client will concern the nurse?

a) I will refrain from taking aspirin for my headache
b) I'm glad I'll be able to eat lettuce, spinach and other green vegetables
c) I will use soft-bristled toothbrush
d) I will drink 8-10 glasses of water everyday

24. Which of the following complaints when made by the client who is receiving penicillin should concern the nurse most?

a) erythema in the lips and eyelids
b) difficulty in swallowing
c) itchiness of the skin
d) dryness of the mouth

25. What assessment parameter will the nurse check prior to giving potassium supplement per slow IV infusion drip?

a) blood pressure
b) complete blood count
c) liver enzymes
d) urine output



ANSWERS AND RATIONALE

21) D
- PTU is antithyroid. It will relieve the signs and symptoms of hyperthyroidism. Pulse will be decreased and the client will also gain weight. Exopthalmos is irreversible. There is no edema in hyperthyroidism.

22) B
- adrenal insufficiency (addison's disease) requires steroid therapy (hormonal replacement therapy), like hydrocortisone.

23) B
- green leafy vegetables are rich in Vit. K which is antagonizes coumadin, and anticoagulant.

24) B
- spasm of smooth muscles, like difficulty in swallowing indicates severe allergic reaction to penicillin.

25) D
- when a client will receive KCl/slow IV drip, urine output must be adequate to prevent renal damage. "No PEE, No K."


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Online Nursing Practice Test about Pharmacology (16-20)

16. The client with liver cirrhosis has an ammonia level of 80 mcg/dl. Which of the following medications does the nurse anticipate to be ordered for the client?

a) dulcolax
b) metamucil
c) lactulose
d) senokot

17. Which of the following indicates effectiveness of Spirolactone, in the client with liver cirrhosis?

a) increase in weight
b) decrease in abdominal girth
c) increase in serum potassium level
d) decrease in jaundice

18. Which of the following is a contraindication to influenza vaccine?

a) chronic illness
b) allergy to eggs
c) diabetes mellitus
d) chronic obstructive pulmonary disease

19. Sulfasalazine (Azulfidine) is prescribed for a client with a diagnosis of ulcerative colitis. A nurse instructs the client about the medication. Which statement when made by the client indicates that he understands the teaching about the medication?

a) I should avoid exposure to sunlight
b) this medication will cause constipation
c) this medication should be taken with meals
d) this medication should be taken as prescribed

20. Which of the following assessment data when made by the nurse indicates effectiveness of lithium?

a) the client paces along the hallway during the night
b) the client refuses to eat in the dining room
c) the client is able to attend the conference on time
d) the client washes his hands less frequently



ANSWERS AND RATIONALE

16) C
- lactulose blocks ammonia formation. The normal serum ammonia level is 35-65 mcg/dL.

17) B
- spirolactone is a diuretic. It increases urine output, and reduces ascites in clients with liver cirrhosis. Therefore, decrease in abdominal girth indicates resolution of ascites.

18) B
- allergy to eggs is contraindication to influenza vaccine.

19) A
- sulfonamides cause photosensitivity. The client should avoid exposure to sunlight

20) C
- lithium is antimanic. Improved attention span and concentration ability indicate that the manic behavior is resolving. These indicate effectiveness of lithium.



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Online Nursing Practice Test about Pharmacology (11-15)





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11. A patient who is known to be a narcotic abuser is involved in an automobile accident and has extensive surgery. In planning for analgesia post-surgery, the nurse should be aware that this patient is likely to:

a) tolerate pain than a patient who is not a drug abuser
b) require greater doses of medication before pain is relieved
c) refuse medication to prove addiction is not a problem
d) tolerate oral medication better than intravenous doses

12. When a patient is taking an antianxiety drug, such as Alprazolam (Xanax), the nurse should instruct the patient to:

a) avoid alcoholic beverages
b) increase potassium intake
c) discontinue use of drugs like tylenol
d) check for signs of edema

13. A client is to receive morphine sulfate 10mg IM. The morphine for injection is available in 8 mg per 1 ml. How many ml should the client receive?

14. A newborn baby boy was given Aquamephyton. The mother asks the purpose of the medication. Which of the following is most appropriate explanation to the mother?

a) this is given to prevent infectious diseases in the future
b) this is given to prevent blood clot formation
c) this is given to enhance immune system function
d) this is given to prevent bleeding

15. The patient is admitted for treatment of Garamycin IV drip. After 24 hours of receiving the medication, which of the following laboratory results are to be checked? Select all that apply

a) BUN
b) creatinine
c) peak and through
d) glucose
e) protein
f) hemoglobin
g) CBC



ANSWERS AND RATIONALE

11) B
- narcotic tolerance requires greater doses of the medication to obtain the desired therapeutic effect.

12) A
- alcohol is a CNS depressant. It enhances sedative effect of benzodiazepines like Alprazolam. Therefore, the patient should avoid alcoholic beverages when he is taking benzodiazepines.

13) 1.25 ml

D/S x dilution = quantity of drug

10 mg/8 mg x 1ml = 1.25 ml

14) D
- aquamephyton is a vitamin K preparation. It promotes synthesis of prothrombin and other clotting factors. Therefore, it will prevent bleeding.

15) A, B, C, E, F, G
- garamaycin is ototoxic, nephrotoxic, may cause agranulocytosis, thrombocytopenia, anemia, proteinura, and photosensitivity. Peak and through levels are determined to serve as basis for determining and adjusting dosage of the medication.


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Online Nursing Practice Test about Pharmacology (6-10)





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6. The client has hepatic encephalopathy. She is receiving lactulose. What is the expected outcome of the medication?

a) increased level of awareness
b) increased albumin levels
c) increased number of stools
d) increased serum protein levels

7. The nurse is preparing to administer Terbutaline (Brethine) to a multigravid client in preterm labor. Before administering this drug intravenously, the nurse should assess which of the following?

a) hematocrit level
b) weight gain
c) urinary output
d) heart rate

8. The physician orders Betamethasone (Celestone) for a 34-year old multigravid client at 32 weeks gestation who is experiencing preterm labor. The nurse explains that this drug is given for which of the following reasons?

a) to enhance fetal lung maturity
b) to counter the effects of tocolytic therapy
c) to treat chorioamnionitis
d) to decrease neonatal production of surfactant

9. Which of the following comments indicates that a client understands the nurse's teaching about Sertraline (Zoloft)?

a) this medicine will probably cause me to gain weight
b) this medicine can cause delayed ejaculations
c) dry mouth is a permanent side effect of Zoloft
d) I can take my medicine with St. John's wort

10. When the nurse begins to give the patient a prescribed medication, the patient says, "You are poisoning me with the pills you are giving me." Which of these responses by the nurse is most appropriate?

a) tell me why you think I am doing that to you
b) this isn't the first dose I've given you
c) I'll get a fresh package of pills so you can see me open the sealed package
d) are the other nurses giving you these pills?



ANSWERS AND RATIONALE

6) A
- lactulose inhibits ammonia formation and relieves hepatic encephalopathy

7) D
- terbutaline, a beta-adrenergic agonist may cause tachycardia.

8) A
- betamethasone enhances fetal lung maturity. Thereby, increasing chance of fetal survival if preterm delivery is inevitable.

9) B
- Zoloft, an antidepressant can cause decreased libido and sexual dysfunction. It can also cause loss of appetite and weight loss.

10) C
- if a client believes that he is being poisoned, allow him to see that the medications are opened in his presence.


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Online Nursing Practice Test about Pharmacology (1-5)


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1. Which of the following laboratory results shows adverse effect of garamycin?

a) elevated SGOT and SGPT
b) decreased wbc count
c) increased platelet count
d) elevated BUN and serum creatinine

2. The client is on heparin therapy. Which of the following health teaching is essential?

a) use a safety razor to shave
b) use a soft sponge toothbrush
c) take ecotrin for pain
d) use compression support stockings

3. Which of the following medications would the nurse be prepared to administer to a client in liver failure?

a) neomycin and lactulose
b) phenytoin sodium
c) diazepam
d) phenobarbital

4. What is the difference between epidural analgesia and analgesia given through intravenous route?

a) epidural analgesia has longer effect in the body
b) epidural analgesia has more sedative effect
c) epidural analgesia is more effective in relieving pain
d) epidural analgesia has fewer side effects

5. A client is receiving Synthroid. Which of the following assessment data indicates that the client is experiencing a side effect of the drug?

a) muscle weakness and fatigue
b) headache and lethargy
c) tachycardia and weight loss
d) anorexia and obesity



ANSWERS AND RATIONALE

1) D
- garamycin is an aminoglycoside. It is nephrotoxic and ototoxic. Nephrotoxicity is indicated by elevated BUN and serum creatinine.

2) B
- heparin is an anticoagulant. Avoid factors that may cause bleeding. Use soft bristled/soft sponge toothbrush to prevent gum bleeding. Ecotrin (ASA) may cause bleeding. Electric razor, and not safety razor is recommended to prevent trauma.

3) A
- neomycin and lactulose block ammonia formation. These are indicated to relieve hepatic encephalopathy. Neomycin reduces colonic bacteria which are responsible for ammonia formation. Lactulose acidifies the colon and inhibits formation of alkaline ammonia.

4) A
- epidural analgesia has longer effect on the body.

5) C
- synthroid is a thyroid preparation. This may cause hypersensitivity of the thyroid gland as manifested by tachycardia and weight loss.

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