Pharmacology 1 Final Exam Questions and Answers PDF

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final exam questions and answers and rationale behind them. 23 chapters for Pharmacology 1 but not pharm 2......

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PHARM QUESTIONS Question 8, Ch 35 Type: MCSA The client has MRSA and receives vancomycin (Vancocin) intravenously (IV). The nurse assesses an upper body rash and decreased urine output. What is the nurse's priority action? 1. Hold the next dose of vancomycin (Vancocin) and notify the physician. 2. Obtain a stat X-ray and notify the physician. 3. Administer an antihistamine and notify the physician. 4. Obtain a sterile urine specimen and notify the physician. Linezolid (Zyvox) is one of two drugs in a class of antibiotics called the oxazolidinones. Linezolid is an alternative to vancomycin for treating MRSA infections. It also is approved to treat VRE infections. The drug is administered IV or PO. Most patients can be converted from IV to PO in about 5 days PG 555 PHARM TXTBK.

Question 22, Ch 35 Following surgery, a client is placed on cefotaxime (Claforan). The assessment for possible adverse effects should include observing for 1. diarrhea. 2. headache. 3. constipation. 4. tachycardia.

Question 17, Ch 35 Type: MCSA Discharge planning for the client prescribed tetracycline will include which instruction? 1. Take the medication with antacids. 2. Take the medication with iron supplements. 3. Do not take the medication with milk. 4. Decrease the amount of vitamins. Question 13, Ch 35 Type: MCSA The physician orders penicillin for a female client who has a sinus infection. What is a priority question to ask the client prior to administering the medication? 1. "Are you pregnant?" 2. "Do you plan to become pregnant?" 3. "Are you breastfeeding?" 4. "Are you taking birth control pills? Question 10, Ch 36 Type: MCSA The female client has a fungal infection and will receive nystatin (Mycostatin). What assessment data is critical for the nurse to review prior to administering this medication? 1. The type of diet the client is eating 2. The amount of fat in the client's diet 3. Whether the patient could be pregnant 4. The client's height and weight Ch 34, Q 30

Question 30 Type: MCMA A patient has taken two doses of interferon Alfa-2b (Intron-A). He comes to the clinic today with the following complaints. Which symptoms would the nurse identify as common adverse effects of this therapy? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. “I am so dizzy.” 2. “I have an itchy rash on my legs.” 3. “I have no appetite.” 4. “I am so tired.” 5. “My bones ache.” Correct Answer: 1,3,4

Question 7, Ch 36 Type: MCSA The client receives nystatin (Nilstat) for a fungal infection in the mouth. The nurse plans to do medication education prior to discharge. What will the best plan by the nurse include? 1. Dissolve the oral tablet in your mouth and then swallow it. 2. Take the oral suspension with a straw to prevent tooth discoloration. 3. Crush the oral tablet, mix it with orange juice, and then swallow it. 4. Swallow the oral tablet whole without chewing or crushing it.

Question 23, Ch 36 Type: MCMA An infant is prescribed nystatin (Mycostatin) for treatment of infant oral candidiasis, or thrush. Which information should the nurse provide to the infant’s caregiver in regard to this medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Give the medication right before a feeding. 2. Give the infant a small amount of water prior to administering the medication. 3. Use a cotton swab to place medication in several parts of the infant’s mouth. 4. The infant should not breastfeed until this infection is gone. 5. The breastfeeding mother may also require treatment.

Question 16, Ch 37 Type: MCSA Which drug is most likely to be ordered for the client with herpes simplex virus? 1. Acyclovir (Zovirax) 2. Zidovudine (Retrovir) 3. Nystatin (Fungizone) 4. Metronidazole (Flagyl)

Chapter 16 Question 4 Type: MCSA The patient receives imipramine (Tofranil) as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the priority assessment by the nurse include? 1. The patient's cardiac status 2. The patient's liver function 3. The patient's renal status 4. The patient's neurological function Correct Answer: 1 Rationale 1: Tricyclic antidepressants are cardiotoxic. An overdose could result in a fatal dysrhythmia. Cardiac status is the primary assessment. Page Number: 189 Question 5 Type: MCSA The patient has been receiving amitriptyline (Elavil) for 2 weeks. He tells the nurse he doesn't think this medicine is working, as he is still depressed. What is the best response by the nurse? 1. "It is working, but it can take several weeks to have an effect." 2. "You might still feel depressed, but you are looking much better." 3. "This may not be the best medicine for you; I'll call your doctor." 4. "It is working, but it can take several months to have an effect." Correct Answer: 1 Rationale 1: The therapeutic effects of tricyclic antidepressants may take 2 to 6 weeks to occur. Page Number: 212

Question 6 Type: MCSA The physician has prescribed sertraline (Zoloft) for the patient who is anxious and depressed. The patient calls the nurse to report that he has experienced delayed ejaculation since being on this medication. What is the best response by the nurse? 1. "I will let your doctor know, and he will most likely change your medication." 2. "This does happen, but treating your depression is a bigger priority." 3. "I am concerned that you will become suicidal if you stop the medication." 4. "Keep taking the medicine, as this usually goes away after a few months." Correct Answer: 1 Rationale 1: One of the most common side effects of the selective serotonin reuptake inhibitors (SSRIs) relates to sexual dysfunction; up to 70% or men and women can experience this. In men, delayed ejaculation and impotence may occur. Page Number: 203 Question 7 Type: MCSA The patient has been depressed, and the physician plans to begin treatment with an antidepressant medication. In performing the initial assessment, what is the most important question for the nurse to ask? 1. "How much alcohol do you consume during the week?" 2. "Are you allergic to any medications?" 3. "How long have you been depressed?" 4. "Have you had any thoughts about killing yourself?" Correct Answer: 4 Rationale 4: The nurse should always assess for suicidal ideation in any depressed patient who is about to begin antidepressant treatment. The medication takes several weeks before the full benefit is obtained. This is a safety issue. Page Number: 212

Question 11 Type: MCSA The patient asks the nurse why she needs to continue using table salt because her prescribed lithium (Eskalith) is a salt. What is the best response by the nurse? 1. "You must continue to use salt to avoid lithium (Eskalith) toxicity. If you use sea salt, you don't need as much." 2. "You must use table salt or your kidneys will retain lithium (Eskalith), and you will become toxic." 3. "The amount is not important; just increase your table salt if you notice signs of lithium (Eskalith) toxicity." 4. "Salt is very important to avoid lithium (Eskalith) toxicity, but not as important as drinking 1 to 1.5 L of water per day." Correct Answer: 2 Rationale 2: The kidneys are responsible for maintaining normal sodium levels. If there is sodium depletion, the kidneys will conserve any salt, in this case lithium (Eskalith). This will lead to lithium (Eskalith) toxicity. Page Number: 213 Question 14 Type: MCSA A patient was prescribed sertraline (Zoloft) for the treatment of depression and anxiety. The patient’s spouse calls the clinic and reports the patient is increasingly moody and seems “disconnected with life.” What is the best response by the nurse? 1. "Try giving him some diphenhydramine (Benadryl) to see if that helps him relax." 2. "Bring him to the clinic for assessment today.." 3. "Hold his medication today and see if his mood improves." 4. " “Double the daily dose of sertraline (Zoloft) and call us back in three days.” Correct Answer: 2 Rationale 2: Sertraline (Zoloft) increases the risk of suicidal thinking and behavior. The patient must be assessed. Page Number: 206

Chapter 17 Question 2 Type: MCSA The patient with schizophrenia is sitting quietly in a chair. The patient does not respond much to what is happening and has a lack of interest in the environment. How does the nurse interpret this assessment? 1. The patient is most likely very depressed. 2. The patient is most likely hearing voices. 3. The patient is experiencing positive symptoms. 4. The patient is experiencing negative symptoms. Correct Answer: 4 Rationale 4: Negative symptoms are those that subtract from normal behavior. These symptoms include a lack of interest, motivation, responsiveness, or pleasure in daily activities. Page Number: 224 Question 3 Type: MCSA The physician has prescribed haloperidol (Haldol) for the patient with schizophrenia. What is the priority patient outcome? 1. The patient will consume adequate fluids and a high-fiber diet. 2. The patient will be compliant with taking the medication as prescribed. 3. The patient will report a decrease in auditory hallucinations. 4. The patient will report symptoms of restlessness. Correct Answer: 2 Rationale 2: Medication compliance is a priority for patients with schizophrenia. Relapse of symptoms will occur without the medications. Page Number: 230

Question 4 Type: MCSA The nurse is managing the care of a group of patients with schizophrenia. The patients are receiving conventional antipsychotic medications. When assessing for anticholinergic side effects, which would the nurse immediately report to the physician? 1. Acute dystonia 2. Complaint of a severe headache 3. Hypertension 4. Urinary retention Correct Answer: 4 Rationale 4: Urinary retention is an anticholinergic side effect of conventional antipsychotics. This must be reported immediately to the physician. Page Number: 233 Question 8 Type: MCSA The nurse has completed medication education with the patient who is receiving risperidone (Risperdal). The nurse evaluates that the education has been effective when the patient makes which statement? 1. "I must call my doctor if I start to have a lot of nightmares." 2. "I must have my blood work done while taking this medication." 3. "I must call my doctor if I start to lose a lot of weight." 4. "I must call my doctor if I notice any a metallic taste in my mouth." Correct Answer: 2 Rationale 2: Agranulocytosis can be a life-threatening side effect of risperidone (Risperdal), which may also suppress bone marrow and lower infection-fighting ability. It is very important, therefore, that the patient have regular blood work done while on this medication. Page Number: 235

Question 11 Type: MCSA The patient receives aspirin. The nurse assesses an adverse effect to this drug when the patient makes which response? 1. "My stools have been dark in color." 2. "My nose is stuffed up." 3. "Bright lights give me a headache." 4. "I have to get up a lot at night to urinate." Correct Answer: 1 Rationale 1: Aspirin may result in ulceration and bleeding, which would result in darker than normal stools. Page Number: 251 -

Internal bleeding (hematoma, collection of blood in a space, affect on other things (increase in intracranial pressure), upper GI (tarry stools, hematemesis) and lower GI bleeding (melena -blood in stool) hematochezia)

Question 24 Type: MCSA Which statement is accurate concerning the use of aspirin (ASA) to treat pain? 1. High doses are necessary (1 gram) to achieve anticoagulant effects. 2. Enteric-coated capsules are available to reduce GI side effects. 3. Increase consumption of herbs such as garlic and ginger to potentiate the anti-inflammatory effects. 4. In low doses (325 mg), it significantly reduces inflammation. Correct Answer: 2 Rationale 2: Enteric-coated capsules can help prevent bleeding. Page Number: 252

Question 25 Type: MCMA How should the nurse plan to manage caring for patients in pain? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Treat all patients alike. 2. Listen carefully to the patient's comments about pain. 3. Show respect for the patient's preferences. 4. Ask questions about the patient's beliefs and customs regarding pain management. 5. Watch how other nurses provide care to their patients. Correct Answer: 2,3,4 Rationale 2: Careful listening is an important step in providing care. Rationale 3: Showing respect is important in providing care in all areas, including pain management. Rationale 4: The nurse cannot practice what the nurse does not know. Asking questions is the method used to gain information to facilitate sensitive care. Page Number: 240 Chapter 25 Question 7 Type: MCSA The patient has a potassium level of 5.9 mEq/L. The nurse is administering glucose and insulin. The patient's wife says, "He doesn't have diabetes, why is he getting insulin?" What is the best response by the nurse? 1. "Insulin will cause his extra potassium to go into his cells and lower the blood level." 2. "Insulin lowers his blood sugar levels and this is how the extra potassium is excreted." 3. "Insulin is safer than giving laxatives such as Kayexalate." 4. "Insulin will help his kidneys excrete the extra potassium."

Correct Answer: 1 Rationale 1: Serum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. Page Number: 365 Question 22 Type: MCSA Potential causes for respiratory alkalosis include 1. hypotension. 2. hypertension. 3. hypoventilation. 4. hyperventilation. Correct Answer: 4 Rationale 4: Hyperventilation occurs with respiratory alkalosis. Page Number: 369

Chapter 46 Question 1 Type: MCMA The nurse teaches a class on pregnancy to clients in their first trimester. The nurse evaluates that learning has occurred when the clients make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "Ovulation occurs on approximately Day 21 of the ovarian cycle." 2. "Ovulation is caused by a surge of luteinizing hormone." 3. "Ovulation is caused by a surge of human chorionic gonadotropin." 4. "Follicle-stimulating hormone causes ovarian follicles to develop."

5. "The pituitary gland secretes gonadotropin-releasing hormone." Correct Answer: 2,4 Rationale 2: Ovulation is caused by a surge of luteinizing hormone. Rationale 4: Follicle-stimulating hormone causes ovarian follicles to develop. Page Number: 787 Question 2 Type: MCSA A client comes to the women's center and tells the nurse she has had unprotected sex. She asks for emergency contraception. What is the best assessment question for the nurse to ask? 1. "How long ago did you have unprotected sex?" 2. "Did you use a condom?" 3. "What kind of birth control have you used in the past?" 4. "Where are you in your monthly cycle?" Correct Answer: 1 Rationale 1: Choice of emergency contraceptive is guided in some ways by the amount of time since unprotected sex. Page Number: 795 Question 3 Type: MCSA The client receives estrogen for prostate cancer. He asks the nurse why he is receiving a female hormone. What is the best response by the nurse? 1. "It shrinks your cancer by making the cells die at a faster rate." 2. "It eliminates the testosterone that feeds your cancer." 3. "It suppresses secretion of the androgens that make your cancer grow." 4. "It keeps nutrients from getting to, and feeding, your cancer." Correct Answer: 3

Rationale 3: Prostate cancer is usually dependent on androgens for growth; administration of estrogens will suppress androgen secretion. Page Number: 797 Question 5 Type: MCSA The nurse manages care for several clients receiving hormone replacement therapy (HRT). What will the priority assessment by the nurse include as related to side effects? 1. Pain in the calf 2. Decreased libido 3. Low-back pain 4. Chronic fatigue Correct Answer: 1 Rationale 1: Hormone replacement therapy puts the client at risk for thrombophlebitis. The nurse should always assess for calf pain and other symptoms of thrombophlebitis. Page Number: 797

Question 6 Type: MCSA The client is receiving oxytocin (Pitocin) for induction of labor. Which assessment finding will most likely result in the nurse stopping the infusion? 1. Uterine contractions are continuous and sustained. 2. The vaginal exam reveals that the client is entering transition. 3. The client reports that the uterine contractions are strong in intensity. 4. Uterine contractions occur every 2 to 3 minutes and last 40 to 60 seconds. Correct Answer: 1 Rationale 1: Continuous and sustained uterine contractions may lead to uterine rupture.Page Number: 805

Question 7 Type: MCSA A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. What is the best instruction for the nurse to give the client? 1. "Please come into the clinic immediately to have a pregnancy test done." 2. "You might consider another form of birth control if you keep missing your pills." 3. "If you have missed fewer than three of your pills, you do not need to worry." 4. "You should use an alternative form of birth control for the rest of this cycle." Correct Answer: 4 Rationale 4: If more than one pill is missed, the medication will not be effective and conception could occur, so the client must use an alternative form of birth control for the rest of her current cycle. Page Number: 789 Question 9 Type: MCSA The nurse teaches the postpartum client about oxytocin (Pitocin). The nurse evaluates that learning has occurred when the client makes which statement? 1. "It will increase my uterine contractions." 2. "It will increase my volume of fluid loss." 3. "It will increase my vaginal muscle tone." 4. "It will increase my milk production." Correct Answer: 1 Rationale 1: Oxytocin (Pitocin), administered in the postpartum period, causes the smooth muscle of the uterus to contract. Page Number: 800

Question 13 Type: MCSA An adolescent client will receive Depo-Provera as a method of birth control. She asks the nurse how long the drug will be effective. What is the best response by the nurse? 1. 2 months 2. 6 months 3. 1 year 4. 3 months Correct Answer: 4 Rationale 4: Depo-Provera is effective for 3 months. Page Number: 790 Question 15 Type: MCSA Estrogens are secreted by the 1. corpus luteum. 2. anterior pituitary. 3. ovarian follicles. 4. endometrium. Correct Answer: 3 Rationale 3: Estrogens are secreted by the ovarian follicles.Page Number: 787 Question 19 Type: MCSA The nurse explains to a client who is taking oral contraceptives that these drugs can increase risk for 1. thrombophlebitis. 2. hypotension.

3. weight loss. 4. respiratory infection. Correct Answer: 1 Rationale 1: Thrombophlebitis can occur, especially in those who smoke or respiratory infection. Page Number: 792 Question 26 Type: SEQ The nurse educator is reviewing the process of regulation of the female reproductive system. The nurse would arrange these steps in which order beginning with the initial step? 1. A surge of luteinizing hormone (LH) occurs 2. Ovarian follicles mature 3. Secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) 4. Secretion of gonadotropin-releasing hormone (GnRH) 5. The corpus luteum is formed

Standard Text: Click and drag the options below to move them up or down. Correct Answer: 4,3,2,1,5 Page Number: 787

Chapter 39 Question 1 Type: MCSA The client tells the nurse that her symptoms have become worse since she has been using oxymetazoline (Afrin) for nasal congestion. What is the best assessment question for the nurse to ask? 1. "How old is the bottle you are using?" 2. "May I take your temperature?" 3. "Are you using any other inhaled medications?" 4. "How long have you been using the medication?

Question 2 Type: MCSA Which assessment finding, by the nurse, is ...