This test will challenge your knowledge regarding the concept of pharmacology.
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This test will challenge your skills regarding the concept of pharmacology. What you need to know about this test is that all test questions will be shown randomly and choices are arranged randomly every time you start a quiz. Rationales will be shown after you have completed the test, be sure to read them!
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A client is being maintained on heparin therapy for deep vein thrombosis. The nurse must closely monitor which of the following laboratory values?
Question 1 Explanation:
Activated PTT. Heparin is used to prevent further clots from being formed and to prevent the present clot from enlarging. The Activated Prothromboplastin Time (APTT) test is a highly sensitive test to monitor the client on heparin.
The nurse is caring for a client receiving a blood transfusion who develops urticaria one-half hour after the transfusion has begun. What is the first action the nurse should take?
Administer Benadryl and continue the infusion
Stop the infusion
Slow the rate of infusion
Take vital signs and observe for further deterioration
Question 2 Explanation:
This is an indication of an allergy to the plasma protein. The first action of the nurse is to stop the transfusion.
A client is being discharged with a prescription for chlorpromazine (Thorazine). Before leaving for home, which of these findings should the nurse teach the client to report?
Abdominal pain, nausea, diarrhea
Sore throat, fever
Dsypnea, nasal congestion
Change in libido, breast enlargement
Question 3 Explanation:
A sore throat and fever may be symptoms of agranulocytosis, a side effect of chlorpromazine (Thorazine).
The nurse receives an order to give a client iron by deep injection. The nurse know that the reason for this route is to
enhance absorption of the medication
provide more even distribution of the drug
ensure that the entire dose of medication is given
prevent the drug from tissue irritation
Question 4 Explanation:
Deep injection or Z-track is a special method of giving medications via the intramuscular route. Use of this technique prevents irritating or staining medications from being tracked through tissue. Use of Z-track does not affect dose, absorption, or distribution of the drug.
A client with heart failure has Lanoxin (digoxin) ordered. What would the nurse expect to find when evaluating for the therapeutic effectiveness of this drug?
decreased chest pain and decreased blood pressure
diaphoresis with decreased urinary output
increased heart rate with increase respirations
improved respiratory status and increased urinary output
Question 5 Explanation:
Digoxin, a cardiac glycoside, is used in clients with heart failure to slow and strengthen the heartbeat. As cardiac output is improved, renal perfusion is improved and urinary output increases. Clients can become toxic on this drug, with the findings of this toxicity being bradycardia, dysrhythmia, visual and GI disturbances. Clients being treated with digoxin should have their apical pulse evaluated for 1 full minute prior to the administration of the drug.
Why is it important for the nurse to monitor blood pressure in clients receiving antipsychotic drugs?
Most antipsychotic drugs cause elevated blood pressure
This provides information on the amount of sodium allowed in the diet
Orthostatic hypotension is a common side effect
It will indicate the need to institute antiparkinsonian drugs
Question 6 Explanation:
Clients should be made aware of the possibility of dizziness and syncope from postural hypotension for about an hour after receiving medication.
The nurse has given discharge instructions to parents of a child on phenytoin (Dilantin). Which of the following statements suggests that the teaching was effective?
"We will skip the next dose if vomiting or fever occur."
"Our child should brush and floss carefully after every meal."
"We will call the health care provider if the child develops acne."
"When our child is seizure-free for 6 months, we can stop the medication."
Question 7 Explanation:
Phenytoin causes lymphoid hyperplasia that is most noticeable in the gums. Frequent gum massage and careful attention to good oral hygiene may reduce the gingival hyperplasia.
A client is receiving intravenous heparin therapy. What medication should the nurse have available in the event of an overdose of heparin?
Question 8 Explanation:
Protamine binds heparin making it ineffective.
A client has received 2 units of whole blood today following an episode of GI bleeding. Which of the following laboratory reports would the nurse monitor most closely?
Hemoglobin and hematocrit
White blood cells
Question 9 Explanation:
Hemoglobin and hematocrit The post-transfusion hematocrit provides immediate information about red cell replacement and about continued blood loss.
A client with amyotrophic lateral sclerosis has a percutaneous endoscopic gastrostomy (PEG) tube for the administration of feedings and medications. Which nursing action is appropriate?
Pulverize all medications to a powdery condition
Cleanse the skin around the tube daily with hydrogen peroxide
Flush adequately with water before and after using the tube
Squeeze the tube before using it to break up stagnant liquids
Question 10 Explanation:
Flushing the tube before and after use not only provides for good flow and keeps the tube patent, it also provides water to maintain hydration. While medications should be crushed to pass through the tube, it is flushing that moves them through. Stagnant liquids are reduced by flushing after tube use. Cleansing is important, but soap and water are sufficient without the added irritation of hydrogen peroxide.
A client diagnosed with cirrhosis of the liver and ascites is receiving Spironolactone (Aldactone). The nurse understands that this medication spares elimination of which element?
Question 11 Explanation:
If ascites is present in the client with cirrhosis of the liver, potassium-sparing diuretics such as Aldactone should be administered because it inhibits the action of aldosterone on the kidneys.
The nurse has been teaching a client with Insulin Dependent Diabetes Mellitus. Which statement by the client indicates a need for further teaching?
"Since my eyesight is so bad, I ask the nurse to fill several syringes."
"I use a sliding scale to adjust regular insulin to my sugar level."
"I keep my regular insulin bottle in the refrigerator."
"I always make sure to shake the NPH bottle hard to mix it well."
Question 12 Explanation:
The bottle should by rolled gently, not shaken.
Discharge instructions for a client taking alprazolam (Xanax) should include which of the following?
Caffeine beverages can increase the effect of sedative hypnotics
Sedative hypnotics are effective analgesics
Sudden cessation of alprazolam (Xanax) can cause rebound insomnia and nightmares
Avoidance of excessive exercise and high temperature is recommended
Question 13 Explanation:
Sudden cessation of alprazolam (Xanax) can cause rebound insomnia and nightmares.
An antibiotic IM injection for a 2 year-old child is ordered. The total volume of the injection equals 2.0 ml The correct action is to
call to get a smaller volume ordered
administer the medication in 2 separate injections
give the medication in the dorsal gluteal site
check with pharmacy for a liquid form of the medication
Question 14 Explanation:
Intramuscular injections should not exceed a volume of 1 ml for small children. Medication doses exceeding this volume should be split into 2 separate injections of 1.0 ml each. In adults the maximum intramuscular injection volume is 5 ml per site
The nurse is caring for a client with clinical depression who is receiving a MAO inhibitor. When providing instructions about precautions with this medication, which action should the nurse stress to the client as important?
Take the medication with milk
Take frequent naps
Avoid chocolate and cheese
Avoid walking without assistance
Question 15 Explanation:
Foods high in tryptophan, tyramine and caffeine, such as chocolate and cheese may precipitate hypertensive crisis.
A client is recovering from a hip replacement and is taking Tylenol #3 every 3 hours for pain. In checking the client, which finding suggests a side effect of the analgesic?
Decreased platelet count
Bruising at the operative site
No bowel movement for 3 days
Elevated heart rate
Question 16 Explanation:
With opioid analgesics observe for respiratory depression, sedation, and constipation. Bruising is not related to the analgesic, but could be the result of corticosteroids or previously used anticoagulants. Elevated heart rate could be the result of bronchodilators. Some antibiotics can lower platelet count.
While providing home care to a client with congestive heart failure, the nurse is asked how long diuretics must be taken. What is the nurse’s best response?
"As you urinate more, you will need less medication to control fluid."
"Please talk to your health care provider about medications and treatments."
"You will have to take this medication for about a year."
"The medication must be continued so the fluid problem is controlled."
Question 17 Explanation:
This is the most therapeutic response and gives the client accurate information.
A parent asks the school nurse how to eliminate lice from their child. What is the most appropriate response by the nurse?
Apply warm soaks to the head twice daily
Application of pediculicides
Cut the child's hair short to remove the nits
Wash the child's linen and clothing in a bleach solution
Question 18 Explanation:
Treatment of head lice consists of application of pediculicides. Pediculicides vary, and the directions must be followed carefully.
The nurse is teaching a client about precautions with Coumadin therapy. The client should be instructed to avoid which over-the-counter medication?
Cough medicines with guaifenesin
Laxatives containing magnesium salts
Non-steroidal anti-inflammatory drugs
Question 19 Explanation:
Medications with NSAIDS may increase the response to Coumadin (warfarin) and increase the risk of bleeding.
Although nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin) are beneficial in managing arthritis pain, the nurse should caution clients about which of the following common side effects?
Question 20 Explanation:
Nonsteroidal anti-inflammatory drugs taken for long periods of time may cause serious side effects, including bleeding in the gastrointestinal track.
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