ATI Pharmacology Proctored Exam
GRADED A LATEST 2023/2024 QUESTIONS AND ANSWERS
1. An immunizing agent that confers active immunity protects by:
Answer: providing antibodies obtained from immune humans or animals.
2. Antacids should be given one hour apart from most other drugs. Which is the rationale?
Answer: Antacids may interfere with absorption of drugs taken at the same time.
3. Vancomycin should not be used to treat minor infections because it:
Answer: can cause "red man syndrome", a hypertensive crisis that is almost always fatal.
4. The antagonist for a client who has overdosed on morphine is:
Answer: narcan.
5. The most serious adverse reaction to oral contraceptives is:
Answer: thromboembolism.
6. When a client develops tolerance to a drug, the nurse would expect:
Answer: higher dose needed to achieve same effect.
7. Antihyperglycemic agents are prescribed for clients with:
Answer: Type 2 diabetes mellitus.
8. The nurse assesses a client shortly after an intravenous infusion of the osmotic diuretic
mannitol is started. Which finding represents an early adverse effect of mannitol?
Answer: Bounding pulse
9. Compared to other beta adrenergic blockers, cardioselective beta adrenergic blockers:
Answer: are less likely to cause bronchoconstriction.
10. A client who experiences motion sickness during airplane flights obtains a prescription for
meclizine (Antivert). When is the best time to take the drug?
Answer: One hour before the flight
11. Before prescribing a cephalosporin, the nurse practitioner asks if the client is allergic to
penicillin. Why is this important to assess?
Answer: A client who is allergic to penicillin can have a cross sensitivity to cephalosporins.
12. The use of which class of antibiotics should be avoided in children?
Answer: Tetracyclines
13. In a walk-in clinic, clients are often given intramuscular injections. Which drug should be
readily available in case a client has an anaphylactic reaction?
Answer: Epinephrine
14. Thiazide and loop (high ceiling) diuretics are similar in that both:
Answer: decrease tubular reabsorption of sodium and water.
15. Which of the statements by the nurse most accurately describes the effects of declined
plasma albumin levels in older adults?
Answer: "There is an increased risk for adverse effects."
16. To prevent oral fungal infections, the nurse should instruct the client who uses a
beclomethasone inhaler to take which action?
Answer: Rinse the mouth after each use.
17. A client takes ethinyl estradiol/norgestimate (Ortho Tri-Cyclen) birth control pills. She calls
the clinic and relates that she missed her medication yesterday. Which instructions will the nurse
give?
Answer: "Take two pills today then continue on a daily basis."
18. The nurse may administer acetylcysteine (Mucomyst) inhalation to:
Answer: facilitate mucus expectoration.
19. Development of a chronic cough is an adverse effect associated with which class of antihypertensive drugs?
Answer: Angiotensin converting enzyme (ACE) inhibitors
20. The nurse may administer baclofen (Lioresal) for the treatment of which condition?
Answer: Protracted muscle spasticity
21. Oral diazepam (Valium), a benzodiazepine, has been prescribed for a client who has anxiety
and muscle spasms. Which nursing intervention is appropriate for the care of this client?
Answer: Assess for incoordination and daytime drowsiness.
22. The nurse practitioner prescribed anhydrous theophylline (Theo-Dur) for the client with
chronic bronchitis. With which disorder would the nurse practitioner reconsider the use of this
medication?
Answer: Hypertension
23. When a client is receiving intravenous fluid with supplementary potassium chloride, it is
especially important for the nurse to monitor for which potential adverse effect?
Answer: Cardiac dsyrhythmias
24. Which adverse effect is common for a client being treated with the antidepressant fluoxetine
(Prozac)?
Answer: Sexual dysfunction
25. After giving a dose of dextromethorphan, an antitussive, which data reflects evaluation of the
drug's effectiveness?
Answer: Client states that cough has been relieved.
26. Prior to giving a client a dose of digoxin, the nurse counts the apical pulse. If the rate is 62
bpm and regular, which is the appropriate nursing action?
Answer: Give the drug and document the heart rate.
27. Digoxin is started for a client with an atrial arrhythmia. Within three days, the client's heart
rate has decreased from 94 to 74. What action of digitalis explains this change?
Answer: Slowed impulse conduction
28. One mechanism by which antihypertensive drugs lower blood pressure is to:
Answer: dilate peripheral blood vessels.
29. There are many agents that are useful in the treatment of gastric ulcers. Which agent reacts
with hydrochloric acid to form a viscous protective barrier over the ulcer?
Answer: Sucralfate (Carafate)
30. A client whose asthma has been poorly controlled is prescribed cromolyn sodium (Intal) for
inhalation. Client teaching should include which statement by the nurse?
Answer: "Using this drug regularly will reduce the frequency of acute attacks."
31. The combination of aluminum and magnesium in many antacids decreases the risk of:
Answer: diarrhea or constipation.
32. A client who is taking one daily dose of a thiazide diuretic should be instructed to:
Answer: take the medication in morning to avoid nighttime voiding.
33. Which phase of pharmacokinetics is affected most by abnormal liver function?
Answer: Metabolism
34. A medication order is written for ciprofloxacin (Cipro). For which client should the nurse
question use of this medication?
Answer: Child age 10
35. A home health client tells the nurse that she is taking triamterene (Dyrenium) for fluid
retention. She tells the nurse she is using a salt substitute so she will not retain so much water.
What is the most appropriate nursing response?
Answer: "Using a salt substitute with this medication could cause you to have too much
potassium."
36. Orders are written for anticholinergic drugs for each of the following clients. Which order
should the nurse question?
Answer: Atropine combined with opioid analgesics to relieve pain in a 30-year-old client with
urinary calculi.
37. A client with Type I diabetes mellitus is given an injection of neutral protamine hagedorn
(NPH) insulin at 7:00 a.m. In order to prevent a hypoglycemic reaction, the client should have:
Answer: a mid-afternoon snack.
38. Why is carbidopa-levodopa preferred over levodopa alone?
Answer: It decreases the amount of levodopa needed.
39. Which findings are most likely in the client who has taken a toxic dose of a salicylate
(aspirin)?
Answer: Tinnitus and dizziness
40. Which nursing intervention is specifically important when a client is taking an alphablocker, such as doxazosin (Cardura) for hypertension?
Answer: Teach the client how to manage orthostatic hypotension.
41. A client reports taking large amounts of vitamins because she believes they increase her
energy level and will prevent various diseases. Client teaching should include which nursing
response?
Answer: "Large amounts of fat-soluble vitamins can be toxic."
42. An elderly client is prescribed a new drug. Because of the agerelated changes in the kidneys
and liver, it is most important that the nurse assess for:
Answer: signs of drug toxicity.
43. Evidence of effective treatment with a nucleoside reverse transcriptase inhibitor (NRTI), such
as zidovudine is:
Answer: decreased HIV RNA level.
44. When oral iron supplements are prescribed, client teaching should include the fact that:
Answer: diarrhea or constipation may occur.
45. If corticosteroids are discontinued abruptly, a problem that may develop is:
Answer: adrenal gland shut-down.
46. An antiulcer drug that forms a gel to coat and protect the ulcer so that healing can occur is:
Answer: sucralfate (Carafate).
47. The nurse would describe a penicillinase to a client receiving this medication as:
Answer: a bacterial enzyme that can inactivate many penicillins.
48. Drugs given for a systemic effect by any route must be capable of:
Answer: distribution throughout the body.
49. Which statement is made by a client who is experiencing an adverse reaction to
levothyroxine (Synthroid)?
Answer: "I feel like my heart is pounding."
50. Clients receiving intravenous gentamicin (Garamycin) should be assessed closely for:
Answer: hearing loss.
51. The best laxative for clients who have chronic constipation and cannot or will not consume
adequate dietary fiber is a:
Answer: saline cathartic.
52. The presence of Helicobacter pylori is confirmed in a client with peptic ulcer disease. The
nurse may anticipate the use of multiple antibiotics because:
Answer: Helicobacter pylori commonly develop resistance to single drugs.
53. "A disease process characterized by the continued use of a specific psychoactive substance
despite physical, psychologic, or social harm" is the definition of:
Answer: addiction.
54. Which group may represent an increased risk for substance abuse?
Answer: Socioeconomically advantaged clients
55. The only drug commonly used both to prevent and to treat tuberculosis is:
Answer: isoniazid
56. The most serious adverse reaction to morphine is:
Answer: respiratory depression.
57. A client who has received an injection of regular insulin at 0800 complains of feeling sweaty,
weak, hungry, and shaky two hours after the injection. Which drug is indicated for this client?
Answer: Glucagon
58. When a client is prescribed an aminoglycoside, such as gentamicin (Garamycin), which
instruction should be included in the teaching plan?
Answer: "Report to your health care provider any ringing in your ears."
59. When a client is being treated with trimethoprim-sulfamethoxazole (Bactrim) for a urinary
tract infection, it is important to:
Answer: maintain good hydration.
60. Histamine 2 receptor antagonists such as cimetidine (Tagamet) are used to treat peptic ulcers
because they:
Answer: neutralize hydrochloric acid in the stomach.
61. To administer eardrops to a child, the nurse should straighten the external ear canal by
pulling the auricle:
Answer: down and toward the back of the head.
62. A client who has a history of thrombophlebitis is taking warfarin to prevent new clot
formation. He should be cautioned not to take salicylic acid because:
Answer: aspirin increases the effects of warfarin.
63. Which statement by the nurse best explains why nausea, vomiting, and bone marrow
suppression are common adverse effects of cytotoxic antineoplastic drugs?
Answer: Cytotoxic drugs affect the most rapidly dividing cells."
64. Glucocorticoids, such as prednisone (Deltasone), are given cautiously to clients with:
Answer: peptic ulcer disease.
65. Client teaching for the use of sublingual nitroglycerin tablets to relieve angina should include
which nursing instruction:
Answer: "You can take up to three doses, five minutes apart, if needed."
66. Two days after abdominal surgery, a client's bowel sounds are hypoactive and the abdomen is
distended. The physician orders bethanechol (Urecholine), a cholinergic agonist, which acts to:
Answer: stimulate intestinal peristalsis and tone.
67. A client who has been on furosemide (Lasix) for one year reports weakness in her legs,
constipation, palpitations, and lethargy. Her bowel sounds are hypoactive. The nurse should
suspect which complication?
Answer: Hypokalemia
68. The drug of choice to treat a client with status epilepticus is:
Answer: diazepam (Valium).
69. A nurse cautions a client with Parkinson's disease who is taking carbidopa/levodopa
(Sinemet) against taking any monoamine oxidase (MAO) inhibitors because the drug interaction
can cause:
Answer: severe hypertension.
70. A client who is scheduled for cataract surgery has an order for acetazolamide (Diamox)
preoperatively. Is this an appropriate order and, if so, why?
Answer: This type of drug is commonly used before ophthalmic surgery to reduce intraocular
pressure.
71. The purpose of a spacer with a metered-dose inhaler is to:
Answer: increase the amount of drug delivered to the lungs.
72. When a client is using a sympathomimetic (adrenergic) bronchodilator such as albuterol, the
nurse would expect which effect?
Answer: Central nervous system stimulation
73. Fluconazole (Diflucan) is prescribed for the client with a fungal infection in the toenails. The
nurse should instruct the client to contact the nurse practitioner immediately if which adverse
effect occurs?
Answer: Bruising or sore throat
74. The effects of epinephrine include:
Answer: increased pulse and blood pressure.
75. To administer heparin subcutaneously, the nurse should:
Answer: use a 26-gauge, 1⁄2-inch needle to minimize trauma.
76. Digoxin (lanoxin)
Answer: anti dysrhythmic] SE: blurred/double vision
77. Guaifenesin
Answer: can cause drowsiness
78. Estrogen (premarin)
Answer: SE: ↑ risk of Thromboembolism with s/s: SOB, severe headache, vomiting, sudden
acute pain in the calves, legs, chest, abdomen.
79. Doxepin (Sinequan)
Answer: [anticholinergic]
SE: urinary retension, constipation, drying of nasal/oral secretons, ↑ HR
80. Albuterol (Proventil)
Answer: [sympathomimetic/adrenergic beta-2 agonist] Contraindicated: with MAOIs (can ↑
action of albuterol and → HTN crisis); β-blockers can inhibit the therapeutic effects Use: invert
canister, shake before use, rinse mouth after use, w/ new inhaler perform test spray
81. Levothryoxine (T4) Indication
Answer: hypothyroidism RT dysfxn of hypothalamus, pituitary, or thyroid gland
82. Cephalosporins (Keflex)
Answer: allergy to cephalosporins is considered a precaution for taking penicillins
83. Phenobarbital [Barbiturates]
Answer: interventions for anticonvulsant therapy: assess for resp. depression, excess sedation
from toxic effects, IV at than the drugs individually
113. Furosemide (Lasix)
Answer: [loop diuretic] Intervention: check BP before giving to determine baseline; can cause ↓
BP by ↓ circulatory volume or by relaxing venous smooth muscle
114. Ticlopidine (Ticlid)
Answer: prevent coronary artery thombosis; Intervention: check platelet count
115. PRBC (packed red blood cells)
Answer: used as blood replacement when fluid overload is a concern
116. IV medications
Answer: Intervention: assess site for redness/swelling before administration
117. Collagenase (Santy)
Answer: Use: Debride ulcers
118. Interferon
Answer: Use: Prevent viral replication
119. Isotretinoin (Accutane)
Answer: Contra: pregnancy w/ 2 forms of birth control due to teratogenic effects
120. Vaccine
Answer: adv. of live vs attenuated/killed
vaccine: long-lasting active immunity vs partial (passive)
121. Epoetin Alfa (Procrit)
Answer: Indic: treat anemia; SE: headache, HTN, seizures RT Hct rises too quickly
122. Urofollitropin (Fertinex)
Answer: Dosage: admin.
IM based on dose in preceding cycles
SE: ovarian hyperstimulation syndrome.
123. Hypertensive crisis
Answer: S/S: flushed skin, headache, visual changes
124. Acetylcysteine (Mucomyst)
Answer: Indic: prevent liver damage following acetaminophen (Tylenol) overdose. Most
effective if given shortly after ingestion; some protection up to 24 hrs.
125. Montelukast (Singulair)
Answer: Indic: prevent asthma exacerbations; Dose: daily at bedtime; SE: well tolerated
126. Metoclopramide (Reglan)
Answer: has increased sedation when given with Morphine
127. Mannitol
Answer: Caution with pts with heart disease (can precipitate CHF and pulmonary ededa)
128. Diphenhydramine (Benadryl) Precaution
Answer: avoid other CNS depressants such as: alcohol, benzodiazepines, kava
129. Anaphylaxis rxn S/S
Answer: S/S: bronchoconstriction, angioedema, hypotension
130. Mafenide acetate (sulfamylon) Interventions:
Answer: Admin PRN analgesics 30 min prior to tx; apply after daily tubbing to remove previous
cream; Monitor fluid & electrolyte/acid-base balances; schedule wound care > 1 hr before meals;
wear sterile gloves when applying
131. Zidovudine (AZT)
Answer: Dose: take at the times prescribed to prevent resistance development
SE: bone marrow suppression, hepatotoxic, nephrotoxic
132. Thrombocytopenia
Answer: Assess: platelet count
133. Prothrombin time
Answer: evaluate adequacy of extrinsic system & common pathway in clotting mechanism
134. Sulfisoxazole (Gantrisin uses)
Answer: Use: UTI
135. Cyclosporine (Neoral)
Answer: Intervention: Mix w/ orange juice or milk to ↑ palatability; mixed & dispense in a glass
container(since drug binds to plastic); grapefruit juice ↑ cyclosporine levels & ↑ risk of toxicity;
administer immediately after mixing (can separate & settle)
136. Hexacholorphene (pHisoHex)
Answer: [antiseptic solution] Caution: CNS stimulation if sufficient amts are absorbed through
skin or mucous membranes; avoid if pregnant/breastfeeding
137. Auranofin (Ridaura)
Answer: Indic: slows the progression of rheumatoid arthritis; takes 4-6 months of therapy to
achieve therapeutic effect; SE: renal toxicity (less toxic through oral route than IM route), severe
blood dyscrasias, GI rxns
138. Thiazides
Answer: SE: hyperuricemia (common SE); assess: uric acid levels
139. Simvastatin (Zocor)—
Answer: SE: muscle weakness/aches; Assess: Creatine Kinase (released w/ severe muscle
injury)
140. Amitriptyline (Elavil)
Answer: [tricyclic antidepressant] SE: orthostatic hypotension, sedation, & confusion
141. Narcotic (opiate) analgesic
Answer: SE: papillary constriction, ↓BP, ↓HR, ↓GI mobility
142. Antihistamines
Answer: Indic: allergy-induced symptoms
143. Mucolytic
Answer: Indic: ↓ viscosity of mucus plugs making them easier to expel
144. Antitussive
Answer: Indic: used to suppress a cough
145. Decongestant
Answer: Indic: used to treat nasal congestion
146. Bulk-forming laxatives (Metamucil)
Answer: Use: take w/ lg amounts of water to prevent a gel-like mass to ↑ constipation
147. Gentamicin (Garamycin)
Answer: [aminoglycoside antibiotic]; SE: nephrotoxicity & ototoxicity
148. Digoxin [cardiac glycoside]
Answer: that ↓ HR. Interv: assess apical HR for 1 min. Contact DR if HR 10mcg/kg/min) α effects predominate → vasoconstriction
& ↑ BP
174. Parkinson's
Answer: associated with ↓ of dopamine in the substantia nigra (brain)
175. Terbutaline (Brethine)
Answer: SE: tachycardia
176. Dexamethasone (Decadron)
Answer: effects on blood glucose: glucocortoid steroids & stress ↑ blood glucose
177. Narcotics
Answer: M of A: alter perception of pain at the spinal cord & higher levels in the CNS
178. Diuretics
Answer: pt. education: take during the day, report any changes in daily wt.
179. Oral Iron supplement
Answer: adverse SE: gastric irritation → anorexia, nausea, vomiting, constipation
180. Trimethoprim/Sulfamethoxazole (Bactrim)[sulfonamide antibiotic]
Answer: SE: crystalluria that can clog the kidneys; to prevent ↑ fluids to 2-3 liters per day unless
contraindicated
181. Triazolam (Halcion)
Answer: [benzo]—use: do not take with alcohol
182. Theophylline
Answer: therapeutic serum level: 10-20 mcg/mL
183. Treatment for constipation in children
Answer: glycerine suppositories (↑ osmotic pressure-draws fluid into colon) castor oildistasteful & ↓ absorption of fat-soluble vitamins;
184. Cromolyn sodium (Intal)
Answer: indication: asthma prophylaxis (mast cell stabilizer → ↓ release of histamine,
bradykinin, and serotonin that start a cascade of aqllergy symptoms)
185. IM site for 18 month old child
Answer: vastus lateralis
186. Metronidazole (Flagyl)
Answer: education: avoid alcohol (drug inhibits alcohol metabolism → accumulation)
187. Fluticasone (Flovent)
Answer: inhaled steroid]—Indic.: decrease inflammation of the bronchi
188. Status epilepticus
Answer: given via IV route
189. Barbiturate overdose
Answer: RT: respiratory depression
190. Penicillin allergy may ↑ risk for allergy to
Answer: cephalosporins
191. Transdermal patch
Answer: education: rotate the site each time you change the patch
192. Proton pump inhibitors for treatment of:
Answer: GERD
193. Ibuprofen (Motrin)
Answer: Most common SE: GI distress
194. Phenobarbital (Luminal)
Answer: assess: respiratory depression
195. Insulin
Answer: oral hypoglycemic agents are contraindicated during pregnancy—use insulin instead
196. Eye drop administration:
Answer: depress the lower lid and place the medication in the lower conjunctival sac.
197. Ventricula dysrhythmias
Answer: in emergency setting—drug of choice: lidocaine hydrochloride (Xylocaine)
198. Diltizem (Cardizem)
Answer: used for SVT
199. Tocainide HCl (Tonocard)
Answer: used to prevent ventricular arrhythmias
200. Propranolol (Inderal)
Answer: used to prevent/control SVT (esp. assoc. w/ excessive catecholamines)
201. Unconscious type 1 diabetic
Answer: best intervention: admin glucagons IM
202. Anti-convulsant for infants/children
Answer: Phenobarbital (often admin w/ phenytoin)
203. Bipolar
Answer: drug of choice: lithium
204. Tricyclic drugs
Answer: used in treatment of depression
205. MAOI drugs
Answer: used in treatment of depression
206. Benztropine mesylate
Answer: used to treat extrapyramidal effects w/ use of phenothiazines
207. Nasal congestion
Answer: treat with decongestant
208. Anti-tussive
Answer: treat cough
209. Mucolytic
Answer: used to decrease the viscosity of mucus plugs making them easier to expel
210. Atropine
Answer: use: severe symptomatic bradycardia
211. Verapamil (Calan)
Answer: use: ↓ HR
212. Phenytoin (Dilantin)
Answer: therapeutic level: 10-20 mcg/mL
213. A primary care provider prescribes diphenhydramine (Benadryl) 5 mg/kg by mouth every 8
hr for a 2-year-old child with rhinitis. Diphenhydramine is available in a 12 mg/5 mL
concentration. How many mL should the nurse give every 8 hr if the client weighs 13 kg (27 lb)?
Answer: 1. Dose: 5 mg/kg × 13 kg = 65 mg
2. Volume: (65 mg ÷ 12 mg) × 5 mL = 27.08 mL
214. A 60-year-old client questions a nurse about her prescribed medication, raloxifene (Evista).
Recognizing that this medication is a selective estrogen receptor modulator (SERM), the nurse
replies that the medication
Answer: prevents postmenopausal osteoporosis.
215. A 12-year-old client is to receive oral cefaclor (Ceclor) for otitis media. A nurse monitors
the client for which of the following symptoms that may indicate an allergic reaction to the
medication?
Answer: Maculopapular rash and pruritus
216. Which of the following instructions should be included in the discharge teaching plan for a
client taking tetracycline (Tetracyn) to prevent the development of the suprainfection, Candida
albicans?
Answer: Eat a container of yogurt with active cultures daily.
217. A nurse working on a gynecological-obstetrics unit is preparing equipment in anticipation
for prescriptions from the primary care provider for Pitocin (oxytocin) administration to several
of the clients on the unit. For which of the following clients should the nurse anticipate oxytocin
administration? (Select all that apply.)
Answer: • A client admitted for augmentation of labor
• A client admitted for induction of labor
• A client with postpartum uterine hemorrhage
218. A male client comes to the clinic requesting sildenafil (Viagra). Viagra should not be
combined with which of the following?
Answer: Nitroglycerin (Nitrogard) also head ache is a side effect of overdosing
219. A nurse has just completed teaching a 71-year-old client about the flu vaccine. Which of the
following client statements indicates that the nurse's teaching was effective?
Answer: "I will make an appointment for the flu vaccine in late October or early November."
220. A postoperative client has a prescription for oxycodone (OxyContin) to be administered for
postoperative pain. In monitoring the client and reviewing the clientʼs chart prior to the first
administration of the medication, which of the following should give the nurse the most cause for
concern?
Answer: Benign prostatic hypertrophy (BPH)
221. A client is undergoing general anesthesia administered by inhalation for a cholecystectomy.
The nurse in the operating room observes that the client has a temperature of 40°C (104°F) and
significant muscle rigidity. The nurse prepares to assist in the care of the client for which of the
following medical emergencies?
Answer: Malignant hyperthermia
222. A nurse should anticipate that the primary care provider may prescribe polystyrene sulfonate
(Kayexalate) for a client who has a serum potassium of
Answer: 5.4 mEq/L and burn injuries.
223. A client is admitted to the hospital with exacerbation of asthma and is receiving albuterol
(Proventil) nebulizer treatments every 4 hr. If encountered, which central nervous system (CNS)
side effect should the nurse attribute to this medication?
Answer: mild tremors
224. A client with active tuberculosis is started on a regimen of antitubercular medications.
Which of the following is important for a nurse to stress to the client?
Answer: Medication resistance may develop if dose scheduling is irregular.
225. A client is admitted to the emergency department by an ambulance for a heroin overdose.
The client is currently taking methadone (Methadose) that was prescribed through an outpatient
clinic for opioid detoxification. The client is unresponsive and is administered naloxone
(Narcan). The nurse evaluates for which of the following desired responses to this medication?
Answer: Increased respiratory rate
226. A client diagnosed with migraine headaches is prescribed sumatriptan (Imitrex). The nurse
is reinforcing client teaching regarding side effects of the medication and advises the client to
seek immediate medical attention for which of the following symptoms?
Answer: Chest discomfort, pressure, and tightness
227. A client phones the primary care clinic and informs a nurse that he is having a "flare up" of
his gout. He tells the nurse he has been prescribed several medications for his gout and questions
which medication he should take. When reviewing the clientʼs medical record, the nurse notes
the client has a history of migraine headaches. Based on this information, which of the following
medications should the nurse anticipate the primary care provider will prescribe?
Answer: colchicine
228. An older adult client treated for recurring episodes of heart failure has been on long- term
thiazide diuretic therapy. Which of the following findings should the nurse report as an adverse
effect of these medications?
Answer: Hypokalemia
229. A nurse recognizes that a client is experiencing an adverse reaction to a nebulized dose of
ipratropium (Atrovent) if the client reports
Answer: a dry, scratchy throat.
230. A client is prescribed estrogen for the reversal of menopause symptoms. The nurse
recognizes the need for further teaching when the client states,
Answer: "I should immediately report any leg pain or redness, numbness or stiffness, or swelling
to my primary care provider."
231. A client newly diagnosed with peptic ulcer disease is started on the cytoprotective agent
sucralfate (Carafate). What important information should the nurse provide the client regarding
potential interactions of this medication?
Answer: Sucralfate should be taken on an empty stomach before meals and at bedtime.
232. A client diagnosed with bipolar disorder and stabilized with lithium is admitted to the
hospital through the emergency department. The primary care provider's diagnosis includes
accidental overdose of lithium. What is the most important information the nurse can provide the
client with about precautions associated with the administration of lithium?
Answer: Blood levels must be monitored to keep lethal levels from accumulating.
233. An adult female client is placed on cyclosporine (Neoral) after receiving a kidney
transplant. Which of the following client statements indicates that the nurse's teaching about this
medication was effective?
Answer: "I will contact my doctor immediately if I have a fever or sore throat."
234. A nurse is administering oral levothyroxine (Levothroid) to an infant with congenital
thyroid deficiency. Which of the following findings indicates a therapeutic response to this
medication?
Answer: The infant's height and weight will be at the 50th percentile by age 2.
235. A pharmacy supplies a fluticasone (Flovent) inhaler for a client who is hospitalized. The
nurse recognizes that this medication will be of the most benefit to the client with
Answer: chronic asthma who consistently uses the inhaler every 12 hr.
236. A client is in a clinic for an annual physical exam. During the medication review the client
reports daily use of loratadine (Claritin) and occasional use of diphenhydramine (Benadryl) for
allergy relief. The nurse recognizes the potential for medication interactions when the client
reports use of
Answer: barbiturates for sleep.
237. A client is self-administering 5 units of lispro insulin (Humalog) every morning. The nurse
should instruct the client that the best time to administer the lispro insulin is
Answer: no sooner than 15 min before breakfast.
238. A client who has hyperthyroidism (Graves' disease) is taking oral propylthiouracil (PTU).
Which of the following client statements indicates effective teaching regarding this medication?
Answer: "It may take two to three months for the thyroid levels to stabilize."
239. A primary care provider has prescribed enoxaparin (Lovenox), 60 mg subcutaneously. The
nurse should select which of the following as the recommended site to administer this
medication?
Answer: Abdomen at least 1in away from belly button
240. A client is receiving the thrombopoietic growth factor oprelvekin (Interleukin-11). The
nurse recognizes that this medication is being given to correct which abnormal laboratory
finding?
Answer: Platelet count 22,000/mm3
241. A client is receiving naproxen (Aleve) 375 mg 3 times/day by mouth. The nurse observes
the client's stools are becoming darker with a tarry consistency. Which of the following nursing
interventions is most appropriate?
Answer: Give the medication with milk or food
242. The parents of an adolescent male client question the nurse about the possibility of
androgen therapy for their son. The nurse responds appropriately with which of the following
statements?
Answer: Androgens are useful for male clients when puberty will not take place."
243. A nurse is caring for a client with heart failure who is receiving spironolactone. The nurse
should monitor for which of the following electrolyte imbalances related to side effects from this
aldosterone antagonist?
Answer: Hyperkalemia also during Eletrocardio Gram (EKG look for peaked T waves as an
indication of increased K+++
244. A client is receiving long-term glucocorticoid therapy for an inflammatory condition. Which
of the following findings should be reported to the primary care provider?
Answer: chills and fever
245. A client is prescribed alprazolam (Xanax) 0.25 mg three times a day.
Answer: The nurse should independently hold the evening dose if the client is displaying
signs/symptoms of rage.
246. A client is started on haloperidol (Haldol) to control antipsychotic episodes associated with
schizophrenia. The nurse should instruct the client to observe for which of the following
potential adverse medication effects?
Answer: Muscle spasm and parkinsonian symptoms
247. A nurse is administering glucagon intramuscularly to a client. Which of the following
actions will help the nurse evaluate the medication's effectiveness?
Answer: Performing a blood glucose fingerstick
248. A client is receiving amphotericin B intravenously. A nurse observes for what common side
effects occurring within the first 1 to 3 hr of initiating the infusion?
Answer: fever and chills
249. A client is receiving digoxin (Lanoxin) for heart failure. Which of the following clinical
manifestations is an early rather than late sign of medication toxicity?
Answer: Vomiting
250. A nurse is monitoring a client with a history of bulimia in regards to the use of the stimulant
laxative, senna (Senokot). Which of the following client findings supports a suspicion of laxative
abuse?
Answer: The client has no urge to defecate even though stools are in the rectal vault.
251. A client is prescribed diphenoxylate/atropine (Lomotil) for severe diarrhea. Which of the
following statements made by the client indicates a need for further nursing instruction regarding
the self- administration of the medication?
Answer: "I will continue to take the medication as long as necessary until my diarrhea is
resolved."
252. A client recently diagnosed with peptic ulcer disease (PUD) is prescribed antacids by the
primary care provider. The client is being instructed by the nurse on when to take the antacids.
Which of the following responses by the client indicates a correct understanding of when to take
the antacids?
Answer: "I will take my antacid at 1 and 3 hr after each meal and at bedtime."
253. A primary care provider has prescribed phenytoin (Dilantin) 200 mg extended release
capsule every day by mouth for a client.
Answer: The nurse recognizes that the client requires further instruction when the client states
the medication can be chewed.
254. A client with a history of alcoholism is taking acetaminophen (Tylenol) for headaches. The
nurse reviews the client's laboratory report. For which of the following laboratory values should
the acetaminophen use be discontinued immediately?
Answer: An elevated serum bilirubin
255. A client is receiving ferrous sulfate orally. Which of the following findings reported by the
client indicates that the medication is achieving its desired outcome?
Answer: No shortness of breath with exertion
256. A client with Parkinsonʼs disease is taking carbidopa-levodopa (Sinemet) daily. The client
reports he is frustrated that he has "good" days with few symptoms and "bad" days where he has
poor symptom control.
Answer: The nurse understands this phenomenon is seen in clients who need a higher
medication dose to control symptoms.
257. A client is taking metoprolol (Lopressor) for heart failure. The nurse notes that the client's
heart rate is 50 beats/min, and the client has a systolic blood pressure of 90 mm Hg. Which of the
following should the nurse do first?
Answer: Hold the client's medication.
258. A client is prescribed intravenous (IV) heparin by a primary care provider. Which of the
following client statements shows understanding of the rationale for the IV heparin that was
prescribed by the primary care provider?
Answer: "My right leg swelled when I got a blood clot after surgery."
259. A nurse is assisting a client in planning a therapeutic diet to enhance the effectiveness of
cholestyramine (Questran) and avoid possible adverse effects. Which of the following would be
appropriate to incorporate into the plan?
Answer: Select from foods that are low in saturated fat and cholesterol.
260. A client is receiving the thrombolytic medication streptokinase (Kabikinase). Which of the
following findings indicates that the client is experiencing an adverse reaction to the medication
that should be reported to the primary care provider?
Answer: Bleeding from a previous injection site
261. When reviewing medication teaching with a client, a nurse reinforces that which of the
following food and medication interactions can lead to medication toxicity?
Answer: Grapefruit juice and nifedipine (Procardia) also a calcium channel blocker
262. A client receives a prescription for calcium channel blockers. The nurse should expect
which of the following diagnostic tests to be prescribed to obtain baseline data prior to starting
the medication?
Answer: Electrocardiogram (ECG)
263. A client is being discharged with a prescription for warfarin (Coumadin) following
treatment for deep vein thrombosis (DVT). The nurse recognizes that teaching has been effective
when the client states,
Answer: "I will not take any aspirin for pain while I am on warfarin. I will take acetaminophen
instead."
264. A nurse should recognize that which of the following findings indicates the most serious
side effect of vancomycin (Vancocin)?
Answer: Impairment of hearing
265. A client who was prescribed oral contraceptives comes to the clinic for her 4 week followup visit. After discussing the use of oral contraceptives with the client, the nurse recognizes a
need for further client education when the client states,
Answer: "If I miss a dose, I should take two pills the next time the dose is due."
266. A primary care provider has prescribed dextromethorphan (Balminil DM) to a client with a
persistent cough.
Answer: The nurse recognizes that the antitussive is used to stop or reduce the cough.
267. A client with a diagnosis of gastroesophageal reflux disease (GERD) is prescribed
famotidine (Pepcid) 20 mg twice a day. When teaching this client about the proper selfadministration schedule for this medication, the nurse should inform the client that famotidine
should be taken
Answer: 1 hr before meals.
268. Which of the following assessment findings in a client receiving transdermal nitrate therapy
for angina indicates an adverse effect?
Answer: Dizziness when the client stands up
269. At 1130, a nurse administers aspart insulin (NovoLog) to a client with diabetes mellitus.
When is the client at greatest risk for hypoglycemia?
Answer: 1345
270. A client with a diagnosis of cystic fibrosis is prescribed acetylcysteine (Mucomyst).
Answer: A nurse understands that the primary reason for giving this medication to the client is to
thin respiratory secretions.
271. A nurse is reinforcing teaching for a client who has colorectal cancer and is receiving the
platinum compound oxaliplatin (Eloxatin). The client should be taught about which of the
following nutritional interventions?
Answer: Increase the amount of fiber in the diet, such as whole grains.
272. A client is receiving diuretics as part of the pharmacologic therapy for heart failure. Which
of the following client statements indicates the need for further instruction?
Answer: "I will take the diuretic if I experience difficulty breathing or chest pressure."
