Pharmacology Midterm PDF

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Pharmacology Midterm

1. The provider orders a maintenance dose of oral aminophylline, 3 mg/kg every six hours. The client weighs 50 kg. How many milligrams should the nurse administer to the client in a 24-hour period? a. 600 b. 37.5 c. 150 d. 12 2. A client is reporting an inability to breathe nasally because of severe rhinitis. The nurse should identify what important role in breathing that is disrupted when the nasal passages are blocked? a. Exhalation of carbon dioxide b. Phagocytosis of pathogens c. Inspired air is warm and humidified d. Respiratory regulation of acid-base balance 3. A client is being admitted to the floor following a motor vehicle accident. The nurse is aware that physiological and psychological stress will have caused the release of aldosterone. What effect of this should the nurse anticipate? a. Decrease heart rate b. Decreased serum potassium c. Decreased blood pressure d. Decreased serum sodium levels 4. A client’s most recent laboratory work reveals neutropenia. The client will have a diminished capacity for: a. Phagocytosis b. Marking cells for destruction c. Producing memory cells d. complement production 5. A client states that he or she was exposed to chicken pox as a child, but he or she does not understand why that now makes him or her immune to subsequent infections with the same virus. During client teaching, the nurse should describe the actions of what immunoglobulin? a. Immunoglobulin A b. Immunoglobulin M c. Immunoglobulin G d. Immunoglobulin E

6. A client just learned of a highly negative prognosis, which is entirely unexpected. What body responses should the nurse anticipate? a. Decreased sweating, decreased BP, and increased heart rate b. Increased blood pressure (BP), increased heart rate and pupil dilation c. Pupil constriction, increased respiratory rate, and decreased heart rate d. Increased sweating, decreased respiratory rate, and increased BP 7. The nurse is preparing to administer an intramuscular (IM) dose of meperidine to a client in pain. The nurse should identify what factor that will affect the absorption of the drug by route? a. The amount of adipose tissue the client has b. Environmental temperature c. Integrity of the client’s mucous membranes d. Perfusion of blood to the subcutaneous tissue 8. A client has an important presentation to make in 4 hours, and he needs relief from the congestion of seasonal rhinitis. The client calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. What medication is most likely to meet this client’s needs? a. Hydroxyzine b. Loratadine c. Diphenhydramine d. Dexchlorpheniramine 9. A client visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, what medication might be ordered? a. Topical decongestants b. Second-generation antihistamines c. Topical nasal steroid decongestants d. First generation antihistamines 10. The nurse is caring for a client who has a disorder of muscle contraction and relaxation. The nurse should prioritize the assessment of what laboratory value? a. Chloride b. Magnesium c. Calcium d. Potassium 11. The nurse admits a 1-year-old child to the pediatric intensive care unit (ICU) with cryptococcal meningitis. What drug should the nurse anticipate receiving an order for to treat this child? a. Fluconazole b. Griseofulvin

c. Ketoconazole d. Amphotericin B 12. The serum lithium levels of a client with bipolar disorder have risen to the minimum level required to have a therapeutic effect. This client’s serum lithium levels have achieved: a. Critical concentration b. Benefits of active transport c. Dynamic equilibrium d. Stable half-life 13. What assessment finding of a client should the nurse attribute to the stimulation of muscarinic receptors? a. The client’s respiratory rate is 20 breaths/min. b. The client appears agitated. c. The client is drooling d. The client reports pruritis (itching). 14. The nurse has provided client teaching for a client who will be discharged to home on an anti-infective. What statement made by the client indicates the nurse needs to provide additional teaching concerning the use of anti-infective? a. “I will stop taking the antibiotic once my symptoms have resolved” b. “A bacterial culture will be done before antibiotics are prescribed for me.” c. “It’s not unusual to develop diarrhea as a result of taking an antibiotic.” d. “Antibiotics will not help me when I have a viral infection.” 15. A nurse has identified the half-life of a drug that will be administered to a client for the first time. The nursing drug guide states the drug’s half-life is 90 minutes. The nurse should identify what implication of this fact? a. “Ninety minutes after drug levels peak, there will be 50% of the peak level.” b. In 3 hours, there will be no detectable levels of the drug presents in the client’s body. c. Peak drug levels will be achieved 90 minutes after the drug is administered. d. Drug levels will rise steadily after administration, reaching 50% of maximum concentration after 90 minutes. 16. A client has just been told that her cancer has metastasized to her right kidney. An interferon (aldesleukin) has been prescribed to treat this metastasis. What potential benefit should the nurse describe to the client? a. Enhancement of renal function b. Enhancement against opportunistic infection c. Inhibition of tumor growth d. Protection against opportunistic infection

17. A client has been administered phenylephrine, a medication that affects alpha 1receptors. The nurse should anticipate what effects on the client? Select all that apply. a. Drowsiness b. Flushed skin c. Decreased blood glucose d. Increased blood pressure e. Pupil dilation 18. The nurse administers a medication that stimulated the parasympathetic nervous system (PNS). What manifestations would indicate the medication is having the desired effect? Select all that apply. a. Bronchial dilation b. Elevated heart rate c. Hyperactive bowel sounds d. Increased saliva production e. Constricted pupils 19. A client has experienced a seizure. A deficiency in what neurotransmitter may have caused the client’s seizure activity? a. Acetylcholine b. Serotonin c. Gamma-aminobutyric acid (GABA) d. Dopamine 20. The nurse is preparing discharge for four clients. Which client should be advised by the nurse that over-the-counter cold and allergy preparations contain phenylephrine and should be avoided? a. A 62-year old client with gout b. A 47-year old client with hypertension c. A 52-year old client with type 2 diabetes d. A 17-year old client with symptoms of an upper respiratory infection 21. The nurse discovers a client receiving warfarin is bleeding. What drug should the nurse prepare to counteract this drug? a. Protamine sulfate b. Calcium gluconate c. Vitamin E d. Vitamin K 22. A health care provider orders 500 mL of IV solution be administered over 8 hours. If the IV infusion set delivers 15 drops per mL, how many drops per minute should the nurse administer to the client? Round to the nearest whole number. a. 17

b. 18 c. 16 d. 14 23. The nurse is teaching a client about the administration of a nasal spray. What information is most important to include in this discussion? a. Finish the bottle of nasal spray to clear the infection effectively. b. Administer the nasal spray in a prone position. c. Overuse of nasal spray may cause rebound congestion. d. Nasal spray can be shared between family members only. 24. The nurse is caring for an older adult client who has just been prescribed metoprolol 75 mg PO b.i.d. What nursing diagnosis should the nurse prioritize in this client’s immediate care? a. Deficient knowledge regarding drug therapy b. Ineffective airway clearance c. Acute pain d. Risk for falls 25. A 25-year-old female client presents at the clinic with fever, chills, and achy joints. The client is diagnosed with influenza A and ribavirin is prescribed. What does the nurse know should be included in the client teaching about this medication? a. This drug is also an abortifacient. b. This drug is safe during pregnancy. c. Use barrier contraceptives d. Remain on oral contraceptives for at least 1 month after finishing this medication. 26. A postsurgical client is being sent home on enoxaparin. The nurse should describe what benefit of this medication. a. Dissolving any clots that form. b. Stimulating production of certain clotting factors c. Enhancing the flow of blood to peripheral vessels d. Inhibiting the formation of clots 27. A nurse is caring for a client who has been receiving a drug by the intramuscular (IM) route at a dose of 0.25 mg. After discharge, the client will be prescribed the same medication orally at a dose of 2.5 mg. What phenomenon should the nurse describe when explaining the reason for the increased dosage for the oral dose? a. First-past effect b. Active transport c. Glomerular filtration d. Passive diffusion

28. The nurse administers a medication that only stimulates nicotinic receptors. What effects would the nurse expect to occur? Select all that apply. a. Slowing heart rate b. Muscle contraction c. Increased bladder contraction d. Signs and symptoms of stress reaction e. Release of epinephrine from adrenal medulla 29. A client with a gram-negative infection is being treated with an aminoglycoside. What assessment should the nurse prioritize during treatment? a. Breath sounds and oxygen saturation b. Urine output and BUN and creatine levels c. Visual acuity d. Muscle strength and coordination 30. Cytological testing reveals that a client has impaired mitochondrial function. That client is likely to have a deficiency of what substance? a. Acetic acid b. Red blood cells c. Deoxyribonucleic acid (DNA) d. Adenosine triphosphate (ATP) 31. In response to the client’s question about whether drugs are safe, the nurse explains that all medications in the United States undergo rigorous testing controlled by what organization? a. Centers for Disease Control and Prevention (CDC) b. Drug Enforcement Agency (DEA) c. Food and Drug Administration (FDA) d. Joint Commission on Accreditation of Healthcare Organization (JCAHO) 32. A nurse is assessing the client’s home medication use. After listening to the client’s list of current medications, the nurse asks what priority question? a. “Are any of these medications orphan drugs?” b. “Do you take any over-the-counter medications?” c. Are these medications safe to take during pregnancy?” d. “Do you take any generic medications?” 33. A client with rheumatic disease is being prescribed salicylate therapy. The nurse should teach the client to monitor himself or herself for which adverse effects? a. Irritation of oral mucosa b. Visual changes c. Ringing in the ears d. Increased hair growth

34. A cell has produced all the substances necessary for the formation of a new cell. What phase of the cell cycle will occur next? a. M Phase b. S Phase c. G2 Phase d. G0 Phase 35. A client is experiencing an allergy to a penicillin antibiotic. What immunoglobulin (Ig) will most directly relate to this immune response? a. IgE b. IgA c. IgG d. IgM 36. A nurse is providing discharge instructions to a client who is taking atenolol for hypertension. What would the nurse teach the client regarding the possible drug interactions and what the client is advised to avoid? a. Ibuprofen b. Oral contraceptives c. Tetracycline d. Levothyroxine 37. A client is diagnosed with an ascaris infection. The client asks what that best way is to prevent ascaris infections. What would be the nurse’s best response? a. “Avoid heavily populated areas.” b. “Do not share hairbrushes or hats.” c. “Wash hands before eating.” d. “Wash fresh vegetables before eating.” 38. The nurse is describing the differing functions of the sympathetic (SNS) and parasympathetic nervous system to a client. The nurse has explained how the SNS is associated with “Fight-or-flight” reactions. How should the nurse describe the characteristics of the parasympathetic nervous system? a. “Recover and repair” b. “Rest and digest” c. “Reflect and recharge” d. Respond and return” 39. The nurse is caring for a client who has been taking an OTC cold remedy containing pseudoephedrine for the past two days. What assessment finding should the nurse most likely attribute to this medication? a. Heart rate 90 beats/min and blood pressure 142/93 mm Hg b. Drowsiness and reports sleeping for 10 hours the previous day

c. Diaphoresis and oral temperature of 37.9 C (100.2 F) d. Nasal congestion and rhinorrhea 40. What client would be most likely to benefit form the administration of a beta 2-specific adrenergic agonist? a. A client who is having an exacerbation of chronic bronchitis b. A client whose blood pressure is 86/41 mm Hg c. A client who is in atrial fibrillation d. A client whose eyes need to be dilated for an ophthalmic examination 41. A client with a urinary tract infection has been prescribed Bactrim, a medication that is a combination of sulfamethoxazole and trimethoprim. What Is the most likely rationale for the use of a combination antibiotic? a. This drugs’ combined effect exceeds the sum of their individual effects. b. One antibiotic is narrow-spectrum and one is broad spectrum c. It is not possible to culture the microorganisms most likely responsible for the infection. d. One of the antibiotics exists solely to facilitate absorption of the other. 42. The patient is having an acute malarial attack with chills and fever. The nurse knows chills and fever are caused by what? a. Formation of sporozoites into the system b. Rupture of red blood cells due to invasion of merozoites c. Invasion of the tsetse fly into the central nervous system d. Release of amastigotes into the blood vessels 43. The nurse is caring for a client who is taking an adrenergic blocking agent. What assessment would be among the nurse’s priorities? a. Checking blood glucose level b. Assessing heart rate c. Measuring urine output d. Monitoring respiratory rate 44. The nurse is caring for a client whose diabetic nephropathy has resulted in anemia. What is the cause of this client’s anemia? a. Inadequate oxygenation of tissue b. Low serum iron levels c. Low erythropoietin levels d. Lack of B12 and folic acid intake 45. A client in cardiogenic shock is receiving an infusion of dopamine when it is discovered that extravasation has occurred. What action is most appropriate?

a. Remove the iv cannula and irrigate the site with normal saline. b. Administer dilute phentolamine to the site, as prescribed. c. Discontinue the medication and administer a bolus of 250 mL of an isotonic solution. d. Administer 4 to 6 mg acetylcysteine IV as prescribed to perverse tissue integrity. 46. A client is admitted with an asthma attack caused by an allergic reaction to a medication. The immediate release of which substance is most likely causing this severe allergic response? a. Epinephrine b. Histamine c. Antihistamine d. Surfactant 47. The home care nurse is taking care of a client on IV vancomycin for cellulitis of the left calf. The client’s lack of response to treatment suggests possible resistance. What process may have caused this phenomenon? a. Microorganisms may have changed their cell membrane to mimic that of the drug. b. Microorganisms may have stopped healthy somatic cells from reproducing. c. Microorganisms may have produced a chemical that is an antagonist to the drug d. Microorganisms may have altered the blood supply to the infected region. 48. An 82-year-old client is newly diagnosed with Alzheimer’s disease. The client’s adult child asks the nurse how the medication is going to help. What should the nurse explain in layman’s terms? a. The drugs work by increasing Ach levels in the brain and reverse the progression of the disease. b. The drugs work by crossing the blood-brain barrier and decreasing Ach levels in the neuromuscular junctions. c. The drugs work by crossing the blood-brain barrier and cure the disease in the brain. d. The drugs work by increasing acetylcholine (Ach) levels in the brain and slowing the progression of the disease. 49. What is the classification of the drug diazepam? a. GABA b. Benzodiazepine c. Vitamin d. Barbiturate 50. A client presents at the clinic reporting vaginal itching and a clear discharge. The client reports to the nurse that she has been taking an oral antibiotic for 10 days. What is the nurse’s best action?

a. Educate the client about the likelihood of a superinfection caused by the destruction of normal flora. b. Advocate for discontinuation of the drug due to the presence of toxic effects. c. Educate the client about the fact that an overdose may be damaging more than one body system. d. Assess for further signs of an adverse reaction to the antibiotic. 51. A nurse is caring for an 80-year-old client with pneumonia. What would be the most appropriate nursing diagnosis for this client? a. Impaired gas exchange b. Ineffective health maintenance c. Decreased cardiac output d. Risk for aspiration 52. The nurse administers a drug that causes vasoconstriction, contracted piloerection muscles, pupil dilation and urinary retention. What receptor is this drug most likely stimulating? a. Beta 2- receptors b. Beta 1- receptors c. Alpha 2- receptors d. Alpha 1- receptors 53. An 81-year-old client with congestive heart failure has been sent to a cardiologist who prescribes digoxin 125 mcg PO every morning. The pharmacy dispenses pills that contain 0.25 mg of digoxin. How many pills should the nurse teach the client to take every morning? a. 1.5 b. 0.5 c. 1 d. 2 54. The nurse admits a client in acute respiratory distress secondary to pulmonary emboli. What drug will the nurse administer to lyse the clots? a. Fondaparinux b. Urokinase c. Tenecteplase d. Rivaroxaban 55. A client’s muscle weakness has been found to result from a lack of neurotransmitter communication between nerve and muscles. What neurotransmitter is most likely deficient? a. Dopamine b. Gamma-aminobutyric acid (GABA)

c. Acetylcholine d. Serotonin 56. After teaching a group of students about the types of anemia, the instructor determines that the teaching was successful when the students identify which anemia results from an inability to produce the intrinsic factor? a. Folic acid deficiency anemia b. Sickle cell anemia c. Iron deficiency anemia d. Pernicious anemia 57. The nurse is assessing a client. What assessment findings should the nurse interpret as suggesting a sympathetic response? a. Evidence of inflammation and decreased heart rate b. Increase in blood pressure and decreased bowel sounds c. Increased bowel sounds and pupil constriction d. Decreased sweating and respiratory rate 58. The nurse instructs a client taking oral iron preparations about strategies for addressing which potential adverse effect? a. Clay-colored stools b. Frequent flatus c. Hypotension d. Constipation 59. The nurse is preparing to administer morning medications to several clients on the unit. In what client would the use of labetalol most likely be contraindicated? a. A 65-year old client with persistent migraines b. A 26-year old client with viral myocarditis c. A 45-year old client with asthma d. A 42-year old client with primary hypertension 60. Microscopic hair like projections of the nasal cell membranes transport foreign substances toward the throat. What structures perform this role? a. Sinuses b. Goblet cells c. Alveolar sacs d. Cilia 61. A client, newly diagnosed with ulcerative colitis, has been admitted to the short-stay unit. The nurse should anticipate which medication will be ordered for this client? a. Choline magnesium trisalicylate b. Fenoprofen c. Salsalate

d. Balsalazide 62. A client presents at the clinic with a dry nonproductive cough. The client is diagnosed with bronchitis and has been determined that assistance is needed in thinning the sputum so the cough can become productive. What does the nurse expect the provider will prescribe? a. Dextromethorphan b. Hydrocodone c. Benzonatate d. Guaifenesin 63. The nurse admits a 26-year-old client with sickle cell anemia. What drug should the nurse most likely administer? a. Methoxy polyethylene glycol-epoetin beta b. Vitamin B12 c. Leucovorin d. Hydroxyurea 64. A client presents at the clinic with signs...