NURS 6521 Final Exam Advanced Pharmacology: Walden University
(Verified Answers)
Question 1
The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication
patient will take per day?
Answer: 1500 mg
Question 2
A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right
eye. The nurse will teach her to observe for which of the following adverse effects of the drug?
Answer: Lid margin crusting and pruritus
Question 3
A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the
following assessments should the nurse prioritize?
Answer: The peak and trough blood levels
Question 4
A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and
reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds
that she has a very high aPTT. The nurse anticipates that which of the following drugs may be
ordered?
Answer: Protamine sulfate
Question 5
A patient asks the nurse practitioner about food sources such as soybeans and soy products. The
nurse practitioner understands that these foods are considered
Answer: phytoestrogens.
Question 6
An immunocompromised cancer patient has developed cryptococcal meningitis and been
admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most
safely administer this drug?
Answer: Infuse the drug over 2 to 4 hours into a central line using an infusion pump
Question 7
The clinical nurse educator who oversees the emergency department in a children's hospital has
launched an awareness program aimed at reducing drug errors. What measure addresses the most
common cause of incorrect doses in the care of infants and children?
Answer: Having nurses check their math calculations with a colleague before administering a
drug.
Question 8
A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The
nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse's
evaluation of the increase is that
Answer: the increase in the neutrophil count is only transient.
Question 9
A nurse practitioner has administered filgrastim to a diverse group of patients in recent months.
Which of the following patients should the nurse observe for extremely elevated white blood cell
counts following administration of the drug?
Answer: A 19-year-old male receiving radiotherapy
Question 10
A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct
the patient to
Answer: complete the entire course of drug therapy.
Question 11
A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring
and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will
interpret these manifestations as
Answer: common adverse effects of magnesium sulfate.
Question 12
A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse
effects during therapy, the nurse will
Answer: monitor the site of injection.
Question 13
Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The
nurse will advise the patient to avoid
Answer: alcohol.
Question 14
A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for
recurring headaches. The nurse should recommend
Answer: tylenol.
Question 15
A Nurse Practitioner will instruct a patient taking allopurinol to take each dose
Answer: before a meal.
Question 16
After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have
sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic
should recognize that the woman may benefit from
Answer: clomiphene.
Question 17
A 5-year-old boy needs an IM injection. The least painful and most effective injection site would
be the
Answer: ventrogluteal muscle.
Question 18
A woman is receiving prolonged drug therapy during her complicated pregnancy, and it may
pose a risk to both the mother and the fetus. The primary care physician has made dosage
adjustments to minimize adverse effects and prevent toxicity. The nurse should make sure
Answer: that serum levels of the drug are being monitored.
Question 19
A 34-year-old male has been diagnosed with TB and will be started on INH therapy.
The medication history reveals that he currently takes antacids on a regular basis. The nurse will
instruct the patient to take
Answer: antacids not less than 1 hour before or 2 hours after taking INH.
Question 20
The recommended treatment for trichomoniasis is
Answer: Flagyl.
Question 21
A Nurse Practitioner is explaining to a pregnant 21-year-old college student why she cannot
continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug
molecules crossing the placental membrane and entering into the fetal circulation. The nurse tells
the patient that the main reason this happens is because
Answer: drugs compete with the hormones of pregnancy for albumin- binding sites.
Question 22
A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following
assessment findings would most strongly indicate that treatment has been effective?
Answer: The patient's hemoglobin level is 11 g/dL
Question 23
A patient will soon begin targeted therapy as a component of her treatment plan for chronic
leukemia. The nurse is conducting health education about this new aspect of the patient's drug
regimen and the patient has asked about the potential side effects of treatment. How should the
nurse best respond?
Answer: "The adverse effects to targeted therapies are most often a result of the patient's cancer,
not the drugs themselves."
Question 24
A 29-year-old pregnant patient is extremely upset about having to take medication for a preexisting medical condition. She is consumed with fear that her baby will be born with a physical
deformity or a congenital anomaly but knows that she has to take the medication. She talks
constantly about this and is unable to sleep most nights. Which of the following is the most
appropriate nursing diagnosis for this patient is?
Answer: Anxiety related to perceived danger of drug therapy to fetus or infant
Question 25
A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic
hypertrophy (BPH). When providing information about the drug, the nurse will include which of
the following as a risk associated with finasteride therapy?
Answer: Prostatic neoplasia
Question 26
A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct
the patient and family members to report which of the following should it occur?
Answer: Presence of blood in urine or stools
Question 27
A 71-year-old man has just been prescribed finasteride (Proscar). Which of the following
complaints by this patient most likely indicated a need for this drug?
Answer: "Lately, I have to get up three or four times a night to go to the bathroom."
Question 28
A 6-month-old child has developed skin irritation due to an allergic reaction. He has been
prescribed a topical skin ointment. The nurse will consider which of the following before
administering the drug?
Answer: That the infant's skin has greater permeability than that of an adult
Question 29
A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxel for
ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor
for which of the following?
Answer: Neurotoxicity
Question 30
A Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous
leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient
for which of the following?
Answer: Hypoglycemia
Question 31
A Nurse Practitioner will monitor which of the following when assigned to a patient taking
allopurinol for chronic gout who visits the clinic every 2 months?
Answer: Liver function tests
Question 32
A patient has acquired primary hypogonadism and has been prescribed testosterone transdermal
(Androderm) patches. When educating the patient on how to administer the drug, the nurse will
instruct him to
Answer: place the patch on the back, abdomen, upper arms, or thighs.
Question 33
A Nurse Practitioner is performing patient education for a woman who has just been prescribed a
bisphosphonate. Which of the following diagnostic and history findings would have prompted
the woman's care provider to prescribe a bisphosphonate?
Answer: Low bone density and a family history of osteoporosis
Question 34
A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at
each clinic visit?
Answer: Serum cholesterol levels
Question 35
A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His
mother reports that she gives him Tylenol at least three times a day. Which of the following will
the nurse work with the physician to evaluate?
Answer: Hepatic function
Question 36
A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated
with chloramphenicol. The most important nursing action for this patient would be to monitor
Answer: plasma concentrations regularly.
Question 37
Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help
prevent gastrointestinal distress, the nurse will advise the patient to
Answer: stand or sit upright for at least 30 minutes after taking alendronate.
Question 38
Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's
physician has prescribed quinine along with an adjunctive drug. The nurse should question the
physician's order if the patient has a history of
Answer: cardiac arrhythmias.
Question 39
A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to
inform the parents that this drug could cause
Answer: staining of permanent teeth.
Question 40
A Nurse Practitioner is caring for a patient who is at 28 weeks' gestation and is receiving
terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters
should the nurse prioritize?
Answer: Fetal heart rate (FHR)
Question 41
The nurse recognizes that the potential for teratogenic drug effects is not static throughout the
prenatal and postnatal periods. The potential for teratogenic effects is highest during
Answer: the first 2 months of pregnancy.
Question 42
A patient with AIDS has developed a number of secondary infections in recent weeks, including
Kaposi's sarcoma. As a result of this most recent diagnosis, his care team has opted to begin
treatment with interferon alfa-2a. The nurse is aware that this drug will address the etiology of
Kaposi sarcoma by
Answer: inhibiting tumor growth by enhancing inflammation.
Question 43
Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient
to use the topical agent
Answer: once a day.
Question 44
A 66-year-old woman has experienced a significant decline in her quality of life as a result of
worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is
responsible for facilitating this new aspect of the patient's drug regimen. This will involve the
administration of
Answer: weekly subcutaneous injections.
Question 45
A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a
follow-up visit to the clinic, the nurse will question the patient about which of the following?
Answer: Headaches
Question 46
Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer
that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed
filgrastim (Neupogen). Which of the nurse's following assessment questions most directly
addresses a common adverse effect of filgrastim?
Answer: "Do you feel like you're having any pain in your bones?"
Question 47
Which of the following would the nurse include in a teaching plan about the signs and symptoms
of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen?
Answer: Headaches and chest pain
Question 48
A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the
chance that the boy will take his prescribed medication, the nurse should
Answer: offer a choice between liquid and chewable medications, if possible.
Question 49
A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been
experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that
he has begun taking his stepfather's antidepressant to improve his mood. After immediately
phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a
monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of
drugs creates a serious risk of what health problem?
Answer: Hypertensive crisis
Question 50
A Nurse Practitioner is going to administer medication to an infant using a medicine dropper.
The best method is to open the child's mouth by gently squeezing the cheeks and placing the
drops
Answer: in the buccal pouch.
Question 51
A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia).
After baseline physical data are obtained, the nurse will assess the patient's childbearing
potential. The nurse will inform the patient that during sibutramine therapy she should
Answer: use adequate contraception.
Question 52
A pregnant patient who has diabetes has been admitted to the hospital to begin labor. Since the
patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor
contractions. When talking to the patient about the adverse effects of the drug, the nurse should
understand that the most common adverse effects of the drug include
Answer: uterine tachysystole.
Question 53
A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be
taking two medications at home for an extended period. The nurse who is discharging the patient
should provide medication teaching specifically to
Answer: both the boy and his mother regarding all medication issued.
Question 54
A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The
nurse will plan the patient's care to include close monitoring of the drug therapy because
Answer: the patient is at greater risk for high serum levels of the drug.
Question 55
A 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain along with a local
disease flare. The nurse interprets this as an indication of which of the following?
Answer: The tumor responding to treatment
Question 56
A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care
provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate.
The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy
affect the potential use of ciprofloxacin to treat her conjunctivitis?
Answer: The use of ciprofloxacin is contraindicated in pregnancy.
Question 57
A Nurse Practitioner is having difficulty administering a bitter drug to a 5-year-old child. The
nurse should
Answer: offer the child a flavored ice chip or ice pop prior to administering the drug.
Question 58
A woman who is in the second trimester of her first pregnancy has been experiencing frequent
headaches and has sought advice from her nurse practitioner about safe treatment options. What
analgesic can the nurse most safely recommend?
Answer: Acetaminophen
Question 59
A Nurse Practitioner is reviewing the prepregnancy medication regimen of a patient who has just
had a positive pregnancy test. The nurse should be aware of which of the following changes in
pharmacokinetics that accompanies pregnancy?
Answer: Increased drug distribution resulting from hemodynamic changes
Question 60
A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for
recurrent cystitis. Because of the patient's history, the nurse would be sure to discuss with the
woman the use of
Answer: grapefruit juice.
Question 61
On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the
potential benefits of hormone replacement therapy in controlling the symptoms of menopause.
Which of the following responses by the nurse is most appropriate?
Answer: "It's important to balance the possible benefits of HRT with the fact that it might
increase your risk of heart disease and stroke"
Question 62
Drugs have a valid medical use but a high potential for abuse, both psychological and
physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written
prescription cannot be provided at the time. However, a written prescription must be provided
within 72 hours with the words authorization for emergency dispensing written on the
prescription. These prescriptions cannot be refilled. A new prescription must be written each
time. Examples include certain amphetamines and barbiturates. This is scheduled drug
Answer: Schedule 2
Question 63
A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse
effects of the drug therapy, the nurse will closely monitor which of the following?
Answer: Blood counts
Question 64
A child is taking permethrin for head lice. The Nurse Practitioner will instruct her mother to
Answer: stop using creams, ointments, and oils on the child's skin and scalp.
Question 65
An immunocompromised patient in a critical care setting has developed a respiratory infection
that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse
should anticipate that the patient will require treatment with
Answer: vancomycin.
Question 66
An immunocompromised patient with a diagnosis of candidiasis has failed to respond to
conservative therapy and has consequently begun treatment with amphotericin B. The nurse is
aware that this drug achieves a therapeutic effect by way of its influence on
Answer: the permeability of fungal cell walls.
Question 67
A 36-year-old woman with a history of dysmenorrhea has begun treatment with progesterone,
which she will be receiving by the intramuscular route. The nurse participating in the woman's
care should prioritize which of the following potential nursing diagnoses?
Answer: Risk for Injury related to loss of vision or thrombotic events
Question 68
A Nurse Practitioner is explaining the use of acyclovir therapy to a 72-year-old man.
Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of
the patient developing this adverse effect, the nurse will advise him to
Answer: stay well hydrated by drinking at least eight 8-oz glasses of water daily.
Question 69
A 36-year-old patient comes to the clinic and tells the nurse practitioner that she suspects that she
is pregnant. During the initial assessment, the nurse practitioner learns that the patient is
currently taking medications for diabetes, hypertension, and a seizure disorder. The nurse would
be most concerned about which of the following medications?
Answer: Phenytoin (Dilantin)
Question 70
The Nurse Practitioner has established peripheral IV access and begun an infusion of magnesium
sulfate on a 29-year-old antepartum patient who is 35 weeks pregnant. Which of the following
assessment findings most likely prompted the patient's physician to order magnesium sulfate for
this patient?
Answer: Systolic blood pressure readings in excess of 190 mmHg
Question 71
A Nurse Practitioner educator who coordinates the staff education on an oncology unit is
conducting an inservice on targeted therapies. What potential benefit of targeted therapies should
the nurse highlight in this education session?
Answer: Targeted therapies have the potential to damage cancerous cells while leaving normal
body cells less affected.
Question 72
A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing
assessment revealed that she started taking daily vitamin supplements about 2 years ago. To
maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient
to
Answer: take the vitamins at least 2 hours before or after taking ciprofloxacin.
Question 73
A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will
instruct the patient to take the drug
Answer: after meals.
Question 74
A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To
help increase bioavailability of the drug, the nurse will encourage the patient to take the
medication
Answer: with high-fat meals.
Question 75
A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive
in her own home from a home health nurse. The nurse should teach the patient to supplement this
treatment with a diet that is high in
Answer: iron-rich foods such as beans and leafy green vegetables.
Question 76
A male patient has been brought to the emergency department during an episode of status
epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to
Answer: avoid the small veins in the dorsum of the hand or the wrist.
Question 77
A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was
subsequently diagnosed with a pulmonary embolism in the emergency department. The patient
has been started on an intravenous heparin infusion. How does this drug achieve therapeutic
effect?
Answer: By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis
Question 78
A nurse practitioner has been assigned to a 55-year-old woman who has a malignant brain tumor.
The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for
which of the following?
Answer: Respiratory difficulty
Question 79
A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no
breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse
practitioner probably suspects
Answer: PMS.
Question 80
A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will
the patient receive in one dose?
Answer: 2000 mg
Question 81
A Nurse Practitioner has completed a medication reconciliation of a patient who has been
admitted following a motor vehicle accident. Among the many drugs that the patient has received
in the previous year is rituximab. The nurse would be justified in suspecting the patient may have
received treatment for which of the following diseases?
Answer: Non-Hodgkin's lymphoma
Question 82
A male patient is experiencing climacteric symptoms secondary to androgen deficiency. His
physician has prescribed testosterone. The nursing assessment reveals that the patient has had a
myocardial infarction. The combination of testosterone therapy and a history of myocardial
infarction would place that patient at a significantly higher risk of
Answer: hypercholesterolemia.
Question 83
An immunocompromised 7-year-old child was recently discharged home with a peripherallyinserted central line (PIC line) for home antibiotic therapy. He has now been brought to the
emergency department by his mother and father with signs and symptoms of line sepsis. Upon
questioning, the mother states that she has been removing the PIC dressing daily and washing the
site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation?
Answer: Ineffective Family Therapeutic Regimen Management
Question 84
A child is admitted to the burn unit with second and third degree burns on both arms and part of
his or her face. When administering topical medications to the burned areas, the nurse should
Answer: use sterile technique when applying the medication.
Question 85
A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at
home for 2 weeks. The child lives with his mother, grandmother, and four other children between
the ages of 14 months and 7 years. The home health nurse is asked to assess the home
environment to determine if it is appropriate for the child to take his medication at home. Which
of the following will have the greatest impact on the nurse's assessment?
Answer: Where the medications will be stored
Question 86
A 9-year-old boy was bought to his primary care provider by his mother with signs and
symptoms of hookworm infection and will be sent home with a prescription for mebendazole.
When provided patient and family education, the nurse should teach the mother with which of
the following measures to avoid reinfection following treatment?
Answer: The importance of vigilant hygiene for the boy and the other members of the family
Question 87
A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be
started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the
nurse will prepare the patient for an
Answer: electrocardiogram (ECG).
Question 88
Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and
hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the
daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr.
Laird in the burns and plastics unit of the hospital should perform what action when
administering this medication?
Answer: Cleanse the wound of debris prior to applying the silver sulfadiazine
Question 89
A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that
has failed to respond to initial antibiotic treatment. The patient's most recent blood cultures
reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient's blood.
The nurse will anticipate that this patient will likely require intravenous administration of what
antibiotic?
Answer: Vancomycin
Question 90
A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly.
When planning this patient's care, what nursing diagnosis should the nurse prioritize?
Answer: Risk for Infection related to suppressed bone marrow function
Question 91
A Nurse Practitioner is working with a 57-year-old man who is a former intravenous drug abuser.
He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of
the following will the nurse include in her teaching plan for this patient?
Answer: Avoid high-fat foods
Question 92
Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who
is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for
erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa
with his oncologist. Which of the following facts should underlie the nurse's response to Mr.
Lepp?
Answer: The potential benefits of epoetin alfa must be weighed carefully d against the potential
adverse effects in cancer patients.
Question 93
A 66-year-old man has made an appointment with his primary care provider to discuss his recent
erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on
television commercials he has seen. What characteristic of this patient would most likely
contraindicate the use of tadalafil for his ED?
Answer: The patient has unstable angina and uses a nitroglycerin patch
Question 94
A man has a demonstrated history of androgen deficiency and the consequences of this health
problem include an inability to maintain an erection. Which of the following medications would
best address this patient's erectile dysfunction (ED)?
Answer: Exogenous testosterone
Question 95
A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that
may put the baby at risk. The most important assessment the nurse can make is
Answer: whether the pregnant woman uses illegal substances.
Question 96
A Nurse Practitioner is aware that the concept of selective toxicity is foundational to
antimicrobial therapy. Which of the following statements most accurately describes selective
toxicity?
Answer: A drug harms microbes without harming human cells.
Question 97
A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the
nurse will carefully monitor the patient for which of the following?
Answer: Cardiovascular complications
Question 98
A 13-year-old female took a weight loss drug that activated the sympathetic nervous system.
Which of the following assessment findings would the nurse expect?
Answer: Increased cardiac conduction
Question 99
A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When
developing a care plan for this patient, which factor will be most important for the nurse to
consider?
Answer: Dietary habits
Question 100
Which of the following patients will be at the greatest risk for anemia and would be the most
likely candidate for epoetin alfa therapy?
Answer: A 62-year-old male with cancer
