NURS 6521: Advanced Pharmacology final exam
Question 1
A nurse 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 2
Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42year-old patient. When providing education to the patient and his wife, the nurse should inform
the wife about which of the following adverse effects?
Answer: • Low blood pressure
• Vaginal burning
Question 3
A 12-year-old boy is being discharged from the hospital after … 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 4
A 30-year-old African-American woman tested positive for …and is prescribed … 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 6
A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To
maximize the therapeutic effects of the drug, which of the following will the nurse include in
instructions to the patient?
Answer: Take the drug for 1 full week before coming in contact with allergens.
Question 7
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 8
A nurse 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
Answer: drugs compete with the hormones of pregnancy for albumin-binding sites.
Question 9
66-year-old man has made an appointment with his primary care provider to discuss his recent
… and has requested a prescription for …based on television commercials he has seen. What
characteristic of this patient would most likely contraindicate the use of
Answer: The patient has unstable angina and uses a nitroglycerin patch
Question 10
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 11
A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment,
the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The
nurse will advise her to
Answer: perform relaxation techniques after the treatments.
Question 12
A nurse 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 radiation therapy
Question 13
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: Dental hygiene practices
Question 17
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 18
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 medication will be stored
Question 19
A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as
a result of drug errors is higher among infants and children than adults. This fact is primarily due
to
Answer: Immature liver and kidney function in infants and children.
Question 20
A nurse 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 21
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 22
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 orange-tinged urine.
Answer: • staining of permanent teeth.
• sleep deprivation.
• deep muscle pain.
Question 23
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 ..
Apply a layer of silver sulfadiazine that is sufficiently thick to make the wound bed invisible.
Answer: Cleanse the wound of debris prior to applying the silver sulfadiazine
Question 24
A patient has been prescribed daptomycin for a complicated skin infection. Which of the
following will the nurse advise the patient to report immediately?
Answer: Muscle pain or tingling
Question 25
An immunocompromised 7-year-old child was recently discharged home with a … 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, …
Answer: Caregiver
Ineffective Family Therapeutic Regimen Management
Question 26
A patient’s current course of cancer treatment involves the administration of a conjugated
monoclonal antibody. What characteristic of the ?
Answer: The targeted therapy is combination of a monoclonal antibody, a kinase inhibitor, and
an inorganic cytotoxin.
The drug is able to adapt its pharmacokinetics to the etiology of the patient’s cancer.
Question 27
A female patient has been prescribed estrogen therapy. Which of the following will the nurse
advise the patient is a common?
Answer: Breakthrough bleeding
Question 28
A nurse works at a weight management clinic. To which of the following overweight patients
could the nurse safely administer dextroamphetamine?
Answer: A 48 year old Caucasian man who has adult-onset diabetes
Question 29
A patient with a diagnosis of chronic myeloid leukemia has met with her oncologist, who has
recommended treatment with the kinase inhibitor imatinib. What route of administration should
the nurse explain to the patient?
Answer: Oral administration of imatinib in a home setting
Question 37
A nurse is instructing a 19-year-old female patient on the use of fluconazole for candida
vaginitis. A …will be to
Answer: use an alternative form of birth control, if taking an oral contraceptive.
Question 38
A nurse is assigned to a patient who is at 32 weeks’ gestation and is receiving …for 24 hours to
control preterm labor. Which of the following nursing actions will the nurse take to decrease the
risk of hypotension and promote circulation to the fetus?
Answer: Instruct the patient to lie on her left side during the infusion.
Question 39
A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help
reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that
Answer: oral form of marijuana
Question 40
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
Answer: Risk for Injury related to loss of vision or thrombotic events
Question 41
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 … 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 42
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
Answer: vancomycin
Question 43
A nurse is working in a women’s hospital where she is caring for a new mother who is
experiencing postpartum urinary retention. Bethanechol (Urecholine) has been ordered. The
nurse will observe for which of the following?
Answer: Hypertension
Question 44
A patient is pregnant and is at 7 weeks’ gestation. She has type 1 diabetes and has been taking
insulin since she was 13 years old. She asks the nurse if the insulin will be harmful to her baby.
The best response to the patient by the nurse would be
Answer: “Insulin is usually the drug of choice for controlling blood glucose levels during
pregnancy because it does not cross into the placenta.”
Question 58
A female patient is prescribed oprelvekin therapy to treat thrombocytopenia. Which of the
following should the nurse continuously monitor to determine the efficacy and duration of the ?
Answer: Fluid retention/weight gain
Question 59
Which of the following is critical to helping prevent development of resistant strains of
microbes?
Answer: Maintain the optimum duration of the antimicrobial agent
Question 60
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 … The clinician suspects a
bacterial, rather than viral, etiology. How will the patient’s pregnancy affect the potential use …?
Answer: The use of ciprofloxacin is contraindicated in pregnancy
Question 68
A 56-year-old woman will soon begin treatment of her …. What patient teaching should the
nurse provide to this woman?
Answer: you might find that you get a dry mouth or a headache but this does not mean it has to
be discontinued
Question 69
A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect. Which
of the following should be included in the nurse's teaching?
Answer: Penicillin interferes with synthesis of the bacteria cell wall.
Question 70
A nurse is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin
patch for chest pain would not be appropriate. Which of the following will the nurse include in
an explanation?
Answer: A child has a greater body surface area, creating greater permeability resulting in an
increase in absorption of topical agents, which may result in more adverse effects.
Question 71
A patient is being discharged from the hospital and will be taking oxybutynin (Ditropan) for
overactive bladder. The nurse will instruct the patient that she will be taking a medication
Answer: that may be prescribed as a patch and which may cause dry mouth.
Question 72
A nurse 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 98
A nurse 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 99
An oncology nurse is aware of the risks for injury that exist around the preparation,
transportation, and administration of chemotherapeutic agents. In order to reduce these risks of
injury, the nurse should take which of the following actions?
Answer: Prime the IV tubing with an approved IV solution rather than with the drug itself.
Question 100
A nurse is discussing with a 58-year-old male patient the causes of erectile dysfunction in men
over 50 years of age. Which of the following will the nurse inform the patient is the primary
physical cause of erectile dysfunction of men in this age group?
Answer: Atherosclerosis of the penile artery
Question 1
A 57-year-old man is to begin 5-FU therapy for colon cancer. It will be most important for the
nurse to monitor which of the following during the first 72 hours of the initial treatment cycle?
Answer: Cardiac events
Question 2
A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel
movements daily. The nurse will instruct the patient to
Answer: notify the clinic if the stools are black or if there is evidence of blood.
Question 3
A nurse 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 4
A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing
assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of
the following?
Answer: Elevated prothrombin time
Question 5
During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient's
platelet count to be 92,000 cells/mm3. The nurse should do which of the following?
Answer: Consult the prescriber for discontinuation of the drug
Question 6
A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The
nurse is aware that vincristine must always be administered
Answer: through a central line.
Question 7
A nurse is providing patient education to a 50-year-old woman who is taking methotrexate
(MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following
drugs?
Answer: Salicylates
Question 8
A 54-year-old male patient with small-cell lung cancer is receiving etoposide. The nurse will
carefully monitor for which of the following?
Answer: Hypotension
Question 9
A 63-year-old male patient has just begun treatment with IV paclitaxel. About 10 minutes into
the infusion, the nurse becomes concerned about a possible anaphylactic reaction to the drug
because the patient is experiencing
Answer: dyspnea.
Question 10
A nurse 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: Leukopenia
Question 11
A patient with a diagnosis of nonsmall cell lung cancer is currently undergoing chemotherapy. At
the encouragement of a family member, the patient has announced to the nurse his intention to
complement this treatment with a regimen of herbal remedies. How should the nurse respond to
this patient's statement?
Answer: “It's important to discuss what herbs you'll be taking with your doctor or the
pharmacist to make sure there aren't any interactions.”
Question 12
A 56-year-old man with a diagnosis of colorectal cancer has been told by his oncologist that
chemotherapy will have the benefit of shrinking the man's tumor prior to bowel resection
surgery. This patient's physician is describing
Answer: neoadjuvant therapy.
Question 13
An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a
colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which
of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs?
Answer: Cells that have a rapid mitotic rate
Question 14
Prior to administering a dose of 5-FU to a patient with pancreatic cancer, the nurse is conducting
the necessary drug research. The nurse is aware that 5-FU is a cell cycle–specific
chemotherapeutic agent. Which of the following statements best describes cell cycle–specific
drugs?
Answer: They affect cancerous cells during a particular phase of cellular reproduction.
Question 15
An oncology nurse is aware of the risks for injury that exist around the preparation,
transportation, and administration of chemotherapeutic agents. In order to reduce these risks of
injury, the nurse should take which of the following actions?
Answer: Prime the IV tubing with an approved IV solution rather than with the drug itself.
Question 1
A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect. Which
of the following should be included in the nurse's teaching?
Answer: Penicillin interferes with synthesis of the bacteria cell wall.
Question 2
Which of the following statements by a patient indicates to the nurse that additional teaching
concerning the use of antimicrobials is needed?
Answer: “I will stop the antibiotic as soon as I feel better.”
Question 3
A patient is to undergo extensive dental surgery. The dentist prescribes a course of antibiotics
before beginning the procedure and continuing for 5 days after the procedure. This is an example
of which of the following?
Answer: Prophylaxis
Question 4
Which of the following is critical to helping prevent development of resistant strains of microbes
in patients?
Answer: Maintain the optimum duration of the antimicrobial agent
Question 5
A nurse is caring for a patient in the intensive care unit. The patient was admitted 2 hours ago
with a severe infection and was started on empiric therapy. Which of the following tests will be
done to identify drug susceptibility?
Answer: Culture and sensitivity
Question 6
The following patients each have a bacterial infection requiring antibacterial drug therapy.
Which patient will likely require the most long-term follow-up care by the nurse?
Answer: An elderly woman with a recent pacemaker insertion
Question 7
When caring for infants and the elderly who are in need of an antimicrobial agent, the nurse is
aware that when compared with doses for young and middle-aged adults, these patients may
require
Answer: a lower dose.
Question 8
A nurse is caring for an African-American man who has an infection. Which of the following
drug therapies would the nurse question if ordered for this patient?
Answer: A sulfonamide
Question 9
Which of the following nursing actions is most important in achieving successful antimicrobial
therapy with vancomycin?
Answer: Promote adequate intake of fluids and nutrients
Question 10
Which of the following is the most important nursing action to help prevent antimicrobial
resistance in health care settings?
Answer: Good hand-washing between each patient contact
Question 11
A nurse 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 12
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 13
Assessment of a newly-admitted patient reveals the characteristic signs and symptoms of
cellulitis to the back of her hand. A swab of the patient's wound was ordered upon admission, but
the results of culture and sensitivity (C&S) testing are not yet available. What strategy will most
likely be adopted to treat this patient's infection?
Answer: Empiric antimicrobial therapy will be implemented until laboratory results are
available.
Question 14
A nurse has questioned why a patient's physician has prescribed a narrow-spectrum antibiotic
rather than a broad-spectrum drug in the treatment of a patient's infection. Which of the
following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever
possible?
Answer: The use of broad-spectrum antibiotics can create a risk for a superinfection.
Question 15
A 70-year-old woman has been prescribed an antimicrobial drug for the treatment of a urinary
tract infection (UTI). What teaching point should the nurse prioritize when providing patient
education?
Answer: “Make sure that you take all the pills that you're prescribed, even if your infection gets
better.”
