Practical Nursing Pharmacology Exam
Bank
Course Introduction
Practical Nursing Pharmacology provides students with foundational knowledge of pharmacological principles and their practical application in nursing care. The course covers drug classifications, mechanisms of action, indications, contraindications, side effects, and safe medication administration practices. Emphasis is placed on interpreting medication orders, calculating dosages, monitoring patient responses, and educating patients about their medications. Through case studies and hands-on simulations, students develop critical thinking skills necessary to safely and effectively manage pharmacological therapies within the scope of practical nursing practice.
Recommended Textbook
Basic Pharmacology for Nurses 15th Edition by Bruce D. Clayton
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50 Chapters
879 Verified Questions
879 Flashcards
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Page 2
Chapter 1: Definitions, Names, Standards, and Information
Sources
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) Which is the most authoritative reference for medications that are injected?
A) Parenteral Drug Handbook
B) Handbook on Injectable Drugs
C) Drugs and Injections Quarterly
D) Handbook of Nonprescription Drugs
Answer: B
Q2) An older adult experiencing shortness of breath is brought to the hospital by her daughter. While obtaining the medication history from the patient and her daughter, the nurse discovers that neither has a list of the patient's current medications or prescriptions. All the patient has is a weekly pill dispenser that contains four different pills. The prescriptions are filled through the local pharmacy. Which resources are appropriate to use in determining the medication names and doses? (Select all that apply.)
A) Martindale-The Complete Drug Reference
B) Physicians' Desk Reference, Section 4
C) Senior citizens' center
D) Patient's home pharmacy
Answer: B, D
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Chapter 2: Principles of Drug Action and Drug Interactions
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) Which are routes of drug excretion? (Select all that apply.)
A) Gastrointestinal (GI) tract; feces
B) Genitourinary (GU) tract; urine
C) Lymphatic system
D) Circulatory system; blood/plasma
E) Respiratory system; exhalation
Answer: A, B, E
Q2) Which best describes when drug interactions occur?
A) On administration of toxic dosages of a drug
B) On an increase in the pharmacodynamics of bound drugs
C) On the alteration of the effect of one drug by another drug
D) On increase of drug excretion
Answer: C
Q3) What will the nurse need to determine first in order to mix two drugs in the same syringe?
A) Absorption rate of the drugs
B) Compatibility of the drugs
C) Drug blood level of each drug
D) Medication adverse effects
Answer: B
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Chapter 3: Drug Action Across the Life Span
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Sample Questions
Q1) Which classification of medications commonly causes allergic reactions in children?
A) Antacids
B) Analgesics
C) Antibiotics
D) Anticonvulsants
Answer: C
Q2) Which would be considered to reduce accumulation of a drug in a patient who has decreased liver function?
A) Decreasing the time interval between dosages
B) Reducing the dosage
C) Administering the medication intravenously
D) Changing the drug to one that has a longer half-life
Answer: B
Q3) When is the ideal time for a nursing mother to take her own medications?
A) Before the infant latches on to begin to breast-feed
B) As soon as the mother wakes up in the morning
C) Right before the mother goes to sleep at night
D) As soon as the infant finishes breast-feeding
Answer: D
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Page 5
Chapter 4: The Nursing Process and Pharmacology
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Sample Questions
Q1) Which task is included in the assessment step of the nursing process?
A) Establishing patient goals/outcomes
B) Implementation of the nursing care plan
C) Measuring goal/outcome achievement
D) Collecting and communicating data
Q2) A patient is experiencing adverse effects of a medication. Which information obtained by the nurse is subjective?
A) Cough
B) Edema
C) Nausea
D) Tachycardia
Q3) What is the nurse's primary source of information when obtaining a patient history?
A) The physician
B) The patient record
C) The family
D) The patient
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Chapter 5: Patient Education and Health Promotion
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Sample Questions
Q1) Which should the nurse include during discharge in addition to verbal instructions? (Select all that apply.)
A) Written instructions for the patient's reference
B) A phone number of the provider or hospital unit for follow-up questions
C) Written instructions for monitoring of parameters used to evaluate therapy
D) Documentation in the nurse's discharge notes of the nursing and collaborative problems that require continued monitoring and intervention
E) Identification of the patient's unreasonable expectations of therapy
Q2) Which is the most intangible portion of the learning process?
A) Cognitive
B) Affective
C) Psychomotor
D) Eminent
Q3) Which would positively affect readiness to learn?
A) Fear and denial
B) Willingness to attain an optimal level of health
C) Poor cognitive and motor development
D) Lack of trust and confidence in the staff
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Chapter 6: A Review of Arithmetic
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Sample Questions
Q1) 7/10 ÷ 3/5 = _____
Q2) The physician has ordered 3500 units of heparin subcutaneously q12h
Available: Heparin 5000 units/mL What volume of heparin will you administer? _____
Q3) 1 dL = _____ L
Q4) 0.6 \(\div\) 2 = _____
Q5) 3.7 - 1.9 = _____
Q6) 1/200 ÷ 1/150 = _____
Q7) An IV of 750 mL was ordered to run over 6 hours with a set calibration of 10 gtt/mL. After 2 hours you notice that 300 mL has infused. Recalculate the flow rate in gtt/min.
Q8) 0.62 = _____, _____, _____
Q9) 4.302 + 1.88 + 0.009 = _____
Q10) 200 mL of solution containing 2 g of boric acid in water. _____
Q11) 1:45 = _____, _____, _____
Q12) 0.5 \(\div\) 4 = _____
Available: Versapen 112.5 mg/5 mL Page 8
Q13) Health care provider's order: Versapen 2.5 mg/kg qid (patient weighs 20.2 kg).
How many mL will you give? _____
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Chapter 7: Principles of Medication Administration and Medication Safety
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Sample Questions
Q1) Which medication route provides the most rapid onset of a medication, but also poses the greatest risk of adverse effects?
A) Intradermal
B) Subcutaneous
C) Intramuscular
D) Intravenous
Q2) What is the most reliable method to calculate a pediatric patient's medication dosage?
A) Age
B) Height
C) Body surface area (BSA)
D) Placement on a growth scale
Q3) Which action will the nurse take if a dosage is unclear on a health care provider's order?
A) Ask the patient what dosage was given in the past.
B) Ask another physician to determine the correct dosage.
C) Tell the patient that the medication will not be given.
D) Contact the health care provider to verify the correct dosage.
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Chapter 8: Percutaneous Administration
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Sample Questions
Q1) A patient has an infected wound with large amounts of drainage. Which type of dressing would the nurse use?
A) Telfa
B) OpSite
C) DuoDerm
D) AlgiDERM
Q2) Where will the nurse administer a medication that was ordered to be given sublingually?
A) Between the molar teeth and cheek
B) Below the skin surface
C) Under the tongue
D) Into the conjunctival sac
Q3) The nurse is teaching a patient about nitroglycerin ointment. Which is an advantage of this form of the medication?
A) It does not give the patient a bad taste in the mouth.
B) The amount of ointment does not matter in obtaining a therapeutic response.
C) It does not cause headaches as an adverse effect.
D) It provides relief of anginal pain for several hours longer than sublingual medication.
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Chapter 9: Enteral Administration
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Sample Questions
Q1) Which route of administration would be ordered by the health care provider if a patient is vomiting?
A) Gastrostomy tube
B) Intradermal
C) Ophthalmic
D) Rectal
Q2) The nurse is administering an oral medication to a 90-year-old patient who has difficulty swallowing pills. One of the medications to be administered is a spansule-type capsule. What nursing considerations are important in this case? (Select all that apply.)
A) Wash hands before preparing medications and before administration.
B) Crush medications and administer with a soft food such as applesauce.
C) Check the patient's ID band with the MAR to ensure patient rights are followed.
D) Have an 8-ounce glass of water available.
E) Check with the pharmacist to see if the spansule medication comes in a liquid form.
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12
Chapter 10: Parenteral Administration: Safe Preparation
Medications
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Sample Questions
Q1) Which information provided by the nurse is most important to include when teaching a patient about the use of an EpiPen?
A) "Hold the syringe at a 45-degree angle against the skin."
B) "Monitor the expiration date of this medication."
C) "After using the EpiPen, lie down for 1 hour."
D) "Place the syringe in a cartridge prior to using."
Q2) Which syringe will the nurse use to administer insulin subcutaneously to a patient?
A) A syringe calibrated in minims
B) A syringe calibrated in units
C) A syringe calibrated in tenths of mL
D) A syringe calibrated in mL
Q3) Which action by the nurse is most accurate when drawing up medication from an ampule?
A) Consider the rim of the ampule as sterile.
B) Use a filter needle to withdraw the medication.
C) Wrap a paper towel around the neck of the ampule before breaking it.
D) Inject 0.5 mL of air into the ampule before withdrawing the medication.
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Page 13
Chapter 11: Parenteral Administration:
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16 Flashcards
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Sample Questions
Q1) Which is the preferred intramuscular site for injecting a 6-month-old child?
A) Dorsogluteal
B) Abdominal
C) Vastus lateralis
D) Deltoid muscle
Q2) Which assessment by the nurse is most important to obtain prior to performing allergy sensitivity testing?
A) Identify areas of loose connective tissue.
B) Question the patient about frequency of exercise.
C) Determine if the patient is using aspirin.
D) Palpate and measure the size of induration.
Q3) Which action by the nurse is most accurate when administering an intradermal injection?
A) Insert the needle at a 45-degree angle.
B) Inject 0.1 mL.
C) Use a 22-gauge needle.
D) Wipe the site with alcohol after injection.
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Page 14
Chapter 12: Parenteral Administration: Intravenous Route
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Sample Questions
Q1) What will the nurse explain when teaching a patient about a PICC line? (Select all that apply.)
A) The catheter may have a single or double lumen.
B) There is greater risk of clotting and infiltration with this type of catheter.
C) The patient will be receiving infusions continuously to ensure patency.
D) The tip of the catheter may be open or valved.
E) The catheter may be used for drawing blood.
Q2) Which potential complication will the nurse expect in patients with a venous access device?
A) Circulatory overload
B) Extravasation
C) Infection
D) Pain
Q3) What is the composition of hypotonic intravenous solutions such as 0.45% NaCl?
A) Fewer dissolved particles than blood
B) Approximately the same number of dissolved particles as blood
C) Higher concentrations of dissolved particles than blood
D) Electrolytes and dextrose
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15
Chapter 13: Drugs Affecting the Autonomic Nervous System
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Sample Questions
Q1) A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent. Which statement by the patient indicates a need for further teaching?
A) "This medication should not be discontinued suddenly."
B) "This medication lowers my blood pressure by helping me get rid of fluid."
C) "I may not have my usual symptoms of a hypoglycemic reaction while on this drug."
D) "This medication may take a few weeks to work."
Q2) Which body functions are controlled by the autonomic nervous system? (Select all that apply.)
A) Blood pressure
B) Skeletal muscle contraction
C) GI secretion
D) Body temperature
E) Urination
Q3) Why are beta blockers used cautiously in patients with respiratory conditions?
A) They mask the signs and symptoms of acute hypoglycemia.
B) They cause extensive vasodilation and cardiac overload.
C) They may produce severe bronchoconstriction.
D) They increase hypertensive episodes.
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Page 16
Chapter 14: Sedative-Hypnotics
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Which sleep pattern stage diminishes as an effect of aging?
A) Stage I
B) Stage II
C) Stage III
D) Stage IV
Q2) Which disease is associated with insufficient sleep?
A) Cancer
B) Glaucoma
C) Myocardial infarction
D) Renal failure
Q3) A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?
A) Advise the patient to take the medication with food.
B) Assess the patient's blood pressure in sitting and lying positions.
C) Inform the patient to discontinue the medication once sleep improves.
D) Instruct the patient to lie down before taking the medication.
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Chapter 15: Drugs Used for Parkinsons Disease
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Sample Questions
Q1) The nurse is assessing an older patient with Parkinson's disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the health care provider?
A) Constipation
B) Brownish orange urine
C) Drowsiness
D) Dizziness
Q2) What points should be included when teaching a patient about the use of apomorphine for treatment of Parkinson's disease? (Select all that apply.)
A) The restoration of function resulting from stimulation of dopamine receptors is permanent.
B) Apomorphine may be administered intravenously for rapid relief.
C) Apomorphine does not have any opioid activity.
D) A multidose injector pen is commonly used to administer apomorphine.
E) You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan).
F) You may experience sleep attacks or episodes of daytime sleepiness.
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Chapter 16: Drugs Used for Anxiety Disorders
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Sample Questions
Q1) What is the recommended time over which antianxiety medications must be gradually tapered before discontinuation?
A) 1 week
B) 1 month
C) 6 months
D) 1 year
Q2) Which is true regarding psychological drug dependence?
A) It is easier to treat than physiological dependence.
B) It is not considered a true addiction.
C) It is easily controlled by influencing the patient's perceptions.
D) It requires medical intervention to treat.
Q3) The nurse is developing a teaching plan for patients prescribed buspirone (BuSpar). Which information about this medication should be included?
A) There is minimal potential for abuse.
B) Signs of improvement can be seen within 3 days.
C) Sedation is increased compared with other antianxiety medications.
D) It stimulates the action of gamma-aminobutyric acid (GABA).
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19
Chapter 17: Drugs Used for Mood Disorders
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Sample Questions
Q1) Which instructions are most pertinent to include in the discharge teaching of a patient on lithium (Eskalith) who is being discharged? (Select all that apply.)
A) "Persistent vomiting and profuse diarrhea are signs of toxicity and must be reported to the health care provider immediately."
B) "It is important to comply with schedules for blood tests to assess therapeutic levels."
C) "You should avoid food such as Chianti wine and aged cheeses."
D) "The common adverse effects to expect, which are excessive nausea, anorexia, and abdominal cramps, tend to resolve."
E) "You will be gradually weaned off this medication."
F) "Take the medication with food or milk."
Q2) A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine. Which assessment finding alerts the nurse to a potential complication?
A) Constipation
B) Hypotension
C) Neck stiffness
D) Urinary retention
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Page 20
Chapter 18: Drugs Used for Psychoses
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Sample Questions
Q1) Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis?
A) Dystonic reactions
B) Pseudoparkinsonism
C) Akathisia
D) Tardive dyskinesia
Q2) Which is an appropriate nursing intervention for a patient who has recently been prescribed clozapine (Clozaril)?
A) Assess for signs and symptoms of hypoglycemia.
B) Encourage a low-fiber diet.
C) Measure the patient's waist circumference.
D) Monitor for insomnia.
Q3) Which statement is true regarding the adverse effects associated with antipsychotic medications?
A) Tardive dyskinesia is a common, reversible condition.
B) Painful dystonic reactions can occur in the first 72 hours of initiation of therapy.
C) Neuroleptic malignant syndrome (NMS) is a common adverse effect.
D) Pseudoparkinsonian symptoms can cause Parkinson's disease.
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21
Chapter 19: Drugs Used for Seizure Disorders
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Sample Questions
Q1) Which is a guideline for the nurse when administering phenytoin (Dilantin) intravenously?
A) Deliver rapidly.
B) Monitor for signs of tachycardia.
C) Assess for hypertensive crisis.
D) Administer without mixing with other medications.
Q2) Which information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinamide therapy?
A) Nausea, vomiting, and indigestion are common during the initiation of therapy.
B) Avoid taking the medication with food or milk to minimize adverse effects.
C) Sedation, drowsiness, and dizziness tend to worsen with continued therapy.
D) Reducing the dosage of medication will relieve symptoms of nausea.
Q3) Which condition is associated with hydantoin therapy?
A) Postictal state
B) Atonia
C) Seizure threshold reduction
D) Gingival hyperplasia
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Chapter 20: Drugs Used for Pain Management
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Sample Questions
Q1) What is the best way for the nurse to evaluate the effectiveness of the patient's opiate agonist?
A) Ability of the patient to tolerate more activity
B) Increased sleep time throughout the night
C) Reduction of respiratory rate from 24 to 18 breaths/min
D) Verbal report of 2 on a 1 to 10 scale
Q2) When teaching a patient who is starting therapy with NSAIDs, the nurse must be sure to mention drug interactions with which of the following? (Select all that apply.)
A) Warfarin (Coumadin)
B) Lithium (Eskalith)
C) Hydroxyzine (Vistaril)
D) Insulin
E) Diuretics
F) Digitalis (Digoxin)
Q3) What term is used to define an awareness of pain?
A) Tolerance
B) Threshold
C) Perception
D) Sensation
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Chapter 21: Introduction to Cardiovascular Disease and Metabolic Syndrome
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Sample Questions
Q1) Metabolic syndrome includes which key characteristics? (Select all that apply.)
A) Hyperglycemia
B) Abdominal obesity
C) Low high-density lipoproteins
D) Hypertension
E) Osteoporosis
Q2) Drug therapy for initial treatment of metabolic syndrome is targeted at controlling which conditions? (Select all that apply.)
A) Obstructive sleep apnea
B) Diabetes mellitus
C) Hypertension
D) Obesity
E) Dyslipidemia
F) Insulin resistance
Q3) Which instruction by the nurse is accurate to include in a patient's care to manage metabolic syndrome?
A) Encourage the client to exercise 20 minutes every day.
B) Eliminate alcohol intake.
C) Increase simple carbohydrates in the diet.
D) Reduce stress.
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Chapter 22: Drugs Used to Treat Dyslipidemias
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Sample Questions
Q1) Which nutritional concepts are necessary to provide to patients receiving colestipol?
(Select all that apply.)
A) Take on an empty stomach to enhance absorption.
B) Whole grains, raw fruits, and vegetables will minimize constipation.
C) Drink 8 to 10 8-ounce glasses of water daily to eliminate dehydration that is secondary to frequent loose stools.
D) Report signs of vitamin K deficiency, including bleeding gums, dark tarry stools, and coffee ground emesis.
E) Supplemental fat-soluble vitamins may be necessary.
Q2) Why are statins, or HMG-CoA reductase inhibitors, administered at bedtime?
A) The stomach is empty.
B) Metabolic needs of the body are decreased.
C) Cholesterol production is at its peak.
D) The body temperature is increased.
Q3) Which antilipemic agent is most potent?
A) Niacin
B) HMG-CoA reductase inhibitor
C) Bile acid-binding resin
D) Fibric acid
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Page 25
Chapter 23: Drugs Used to Treat Hypertension
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Sample Questions
Q1) The nurse is explaining to a patient how ACE inhibitors affect blood pressure. Which statement accurately describes the action of these medications?
A) They increase aldosterone secretion.
B) They inhibit vasoconstriction.
C) They lower heart rate.
D) They promote sodium retention.
Q2) A patient recently prescribed felodipine (Plendil) for treatment of hypertension is experiencing dizziness when rising to a standing position. Which action will the nurse take?
A) Encourage the patient to sit down if feeling faint.
B) Advise the patient to increase dietary sodium.
C) Inform the patient to discontinue the medication.
D) Instruct the patient to monitor weight daily.
Q3) What is mean arterial pressure (MAP)?
A) The difference between the systolic and diastolic pressures
B) An indicator of the tone of the arterial blood vessel walls
C) The average pressure throughout each cycle of the heartbeat
D) The product of the cardiac output and the peripheral vascular resistance
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26
Chapter 24: Drugs Used to Treat Dysrhythmias
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Sample Questions
Q1) A patient who is started on phenytoin (Dilantin), who is also taking amiodarone (Cordarone), should be assessed for what possible effect?
A) CNS depression and sedation
B) Decrease in effectiveness of phenytoin
C) Respiratory depression
D) Increase in serum phenytoin levels
Q2) Which lidocaine preparation is appropriate for the treatment of cardiac dysrhythmias?
A) 0.1% lidocaine with preservative
B) 2% lidocaine for topical use
C) Lidocaine patch
D) Injectable lidocaine without preservative
Q3) A patient is taking amiodarone (Cordarone) for hypertrophic cardiomyopathy and begins to complain of dizziness. What will the nurse instruct the patient to do?
A) Discontinue the medication immediately.
B) Decrease the medication dosage for 1 week, and then resume the original order.
C) Change positions slowly.
D) Increase the dosage per health care provider directions.
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Chapter 25: Drugs Used to Treat Angina Pectoris
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Sample Questions
Q1) What is the rationale behind administering calcium channel blockers to patients with angina?
A) They decrease heart rate.
B) They dilate blood vessels.
C) They increase cardiac contractility.
D) They promote fluid excretion.
Q2) What risk is minimized when the smallest dose of nitroglycerin is used to provide satisfactory results?
A) Allergy
B) Dependence
C) Tolerance
D) Nausea
Q3) Which statement about ranolazine (Ranexa), a fatty oxidase enzyme inhibitor, is true?
A) It causes coronary artery vasodilation.
B) It causes no gastrointestinal side effects.
C) It causes QT interval prolongation.
D) It elevates LDL levels.
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28
Chapter 26: Drugs Used to Treat Peripheral Vascular Disease
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Sample Questions
Q1) The nurse advises a patient taking papaverine to consult the health care provider or pharmacist before taking which over-the-counter (OTC) medication?
A) Laxatives
B) Cough and cold remedies
C) Vitamin supplements
D) Acetaminophen
Q2) The nurse is assessing the patient's leg for peripheral vascular disease (PVD) and is unable to palpate the pedal pulse in either foot. Which action will the nurse take first?
A) Contact the health care provider for further orders.
B) Request x-ray studies of the lower extremities.
C) Request that the patient lie flat.
D) Obtain a Doppler ultrasound device for auscultation.
Q3) What is the action of pentoxifylline (Trental), a hemorheologic agent used to treat chronic occlusive arteriole disease?
A) Vasodilates the peripheral arteries
B) Potentiates the blood clotting mechanism
C) Increases erythrocyte flexibility
D) Increases blood viscosity
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Chapter 27: Drugs Used to Treat Thromboembolic Disorders
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Sample Questions
Q1) What is the rationale for administering fibrinolytic agents, such as streptokinase, within hours of the onset of myocardial infarction?
A) Enhances myocardial oxygenation
B) Lyses the blood clot
C) Promotes platelet aggregation
D) Inhibits clotting mechanisms
Q2) A trauma patient arrives in the emergency department via EMS. He is bleeding profusely. A medical alert bracelet indicates that he is on heparin therapy. The nurse will most likely administer which medication that counteracts the action of heparin?
A) Warfarin sodium (Coumadin)
B) Enoxaparin (Lovenox)
C) Protamine sulfate
D) Vitamin K
Q3) Which symptom is indicative of bleeding in a patient taking warfarin (Coumadin)?
A) Bradycardia
B) Petechiae
C) Increased urinary output
D) Dry skin
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Chapter 28: Drugs Used to Treat Heart Failure
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Q1) The nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine, a calcium channel blocker. Which statement by the nurse is accurate?
A) "This medication dilates your coronary arteries."
B) "This medication will help your kidneys get rid of fluid."
C) "This medication reduces volume returning to your heart so it doesn't overstretch."
D) "This medication reduces the resistance your heart has to pump against."
Q2) The nurse monitors a patient receiving digoxin closely for toxicity when which other medication is prescribed?
A) Potassium supplements
B) Furosemide (Lasix)
C) Acetylsalicylic acid (aspirin)
D) Antibiotics
Q3) Which action will the nurse implement while providing care to a patient with heart failure?
A) Encourage fluid intake of 2 L/day.
B) Ambulate the patient within 1 hour after eating.
C) Maintain the patient in the supine position.
D) Weigh the patient daily.
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Page 31
Chapter 29: Drugs Used for Diuresis
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Q1) The nurse has provided patient teaching about potassium-sparing diuretic therapy. Which statement by the patient indicates a need for further teaching?
A) "I will take my medication in the morning."
B) "I will report a weight gain of 2 pounds in 2 days."
C) "I will rise slowly when I get up from a sitting position."
D) "I will use a salt substitute because I limit my salt intake."
Q2) The nurse would expect to assess which serum potassium level in a patient who has severe vomiting and diarrhea?
A) Less than 3.5 mEq/L
B) Between 3.5 mEq/L and 4.5 mEq/L
C) Between 4.6 mEq/L and 5 mEq/L
D) Higher than 5.5 mEq/L
Q3) Which patient assessment would alert the nurse to withhold a loop diuretic?
A) Crackles in the lung bases
B) +2 pitting peripheral edema
C) Serum potassium of 2.6 mEq/L
D) Weight gain of 2 pounds in 2 days
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Page 32
Chapter 30: Drugs Used to Treat Upper Respiratory Disease
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Q1) When does allergic rhinitis occur? (Select all that apply.)
A) Nasal mucosa become inflamed.
B) Exposure secondary to an allergen produces inflammation.
C) Histamine is released following allergen exposure.
D) The weather is cold during the winter.
E) A person has an initial exposure to an antigen.
Q2) The nurse is preparing education for a patient who has developed rebound nasal congestion secondary to use of topical decongestants. What information will the nurse include? (Select all that apply.)
A) For future topical decongestant use, follow the dosage directions daily. Do not overuse.
B) Stop the topical decongestant at once.
C) A decrease in congestion will occur immediately.
D) Nasal steroid solutions can be used but may take several days to reduce inflammation and congestion.
E) Use nasal saline spray to moisturize irritated mucosa.
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Chapter 31: Drugs Used to Treat Lower Respiratory Disease
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Q1) Which statements are true regarding the nursing assessment of a patient with a respiratory disorder? (Select all that apply).
A) Central cyanosis typically is observed on the fingers and earlobes.
B) Clubbing of the fingernails is a sign of hypoxia.
C) As oxygen levels diminish, mental alertness will progressively deteriorate.
D) The normal respiratory rate in an adult is 10 breaths/min.
E) Episodes of apnea are present in Cheyne-Stokes.
Q2) A patient has questions regarding a recently prescribed antitussive agent. Which response by the nurse is the best?
A) "It will eliminate your cough at night."
B) "It will reduce the frequency of your cough."
C) "It should be used in the morning."
D) "It should be taken before sleep."
Q3) From where do the fluids of the respiratory tract originate?
A) Specialized mucous glands called goblet cells
B) Lymph fluid drawn across nasal membranes by osmosis
C) Specialized beta cells in the islets of Langerhans
D) Cells that produce aqueous humor
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34
Chapter 32: Drugs Used to Treat Oral Disorders
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Q1) What infection is often called the "disease of the diseased" because it appears in debilitated patients?
A) Aspergillosis
B) Candidiasis
C) Trichomoniasis
D) Brucellosis
Q2) Which information will the nurse include when teaching a patient about cold sores?
A) Use of drying agents prevents the spread of secretions.
B) Erupted lesions are not contagious.
C) Eruptions are related to breaks in personal hygiene.
D) Pus-filled lesions indicate a secondary bacterial infection.
Q3) What is the primary pharmacologic therapy for Candida albicans?
A) Steroids
B) Antifungal agents
C) Topical anesthetics
D) Topical anti-inflammatory agents
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Chapter 33: Drugs Used to Treat Gastroesophageal Reflux and Peptic Ulcer
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Q1) Cimetidine (Tagamet) is an example of which class of drug?
A) Protokinetic agent
B) Proton pump inhibitor
C) Histamine (H2) receptor antagonist
D) Coating agent
Q2) A postoperative appendectomy patient has a nasogastric tube and wonders why the previous nurse told him that he was receiving an IV "ulcer-preventing" medication called ranitidine. The patient states that he has never had any stomach problems in his life. Which is the best response by the nurse?
A) "This medication will cause the pH in your stomach to drop."
B) "This medication helps coat your stomach while the nasogastric tube is in place."
C) "Because you are not eating after surgery, this medication will help reduce the hydrochloric acid your stomach is still secreting."
D) "The nasogastric tube will cause peptic ulcer disease. This medication will help prevent that."
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Chapter 34: Drugs Used to Treat Nausea and Vomiting
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Q1) A patient going on vacation asks the nurse what she can give to her 3-year-old child who becomes car sick. Which responses are accurate? (Select all that apply.)
A) "Positioning techniques such as placing the child facing forward and blocking out scenery through the side windows can be helpful."
B) "There is no such thing as car sickness."
C) "If your child does vomit, there is some over-the-counter Benadryl you can administer."
D) "I would check with the pharmacist regarding over-the-counter products available for young children."
Q2) A patient expresses concerns about motion sickness. Which medication is most effective in preventing motion sickness?
A) Serotonin antagonists
B) Phenothiazines
C) Corticosteroids
D) Anticholinergics
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Chapter 35: Drugs Used to Treat Constipation and Diarrhea
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Q1) The nurse is assessing a patient with constipation. Which are causes of constipation? (Select all that apply.)
A) Diet low in fiber and/or residue
B) Excessive fluid intake
C) Diet low in cheese and yogurt
D) Iron supplements
E) Use of morphine
Q2) A friend reports using loperamide (Imodium) for continual diarrhea for a week since returning home from a vacation outside the country. Which is the nurse's best response?
A) "There are some other over-the-counter products available for diarrhea, such as Kaopectate (bismuth subsalicylate)."
B) "I'd stop taking the Imodium and go in to see a health care provider immediately. You may have an infection in your intestinal tract."
C) "If you're not running a temperature, I wouldn't worry. That happens to many people when they travel."
D) "As long as you can drink plenty of fluids, I'm sure the diarrhea will go away once you're back in a normal routine."
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Chapter 36: Drugs Used to Treat Diabetes Mellitus
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Sample Questions
Q1) Which statements are true about gestational diabetes? (Select all that apply.)
A) It is diagnosed in about 2% of all pregnancies in the United States.
B) It includes diabetic women who become pregnant.
C) Fetal development may be complicated as a result of gestational diabetes.
D) The risk of developing diabetes after pregnancy is increased.
E) Most women with gestational diabetes have normal glucose tolerance post partum.
F) Women need to be reevaluated postpartum to determine their classification with respect to glucose tolerance.
Q2) When is the best time for the nurse to administer Lispro?
A) After the patient has started eating
B) Within 10 to 15 minutes of eating
C) 30 minutes before a meal
D) 45 to 60 minutes before a meal
Q3) What test determines glycemic control over the previous 8 to 10 weeks?
A) 24-hour glucose clearance test
B) Fructosamine test
C) Fasting blood sugar
D) A<sub>1c</sub> test
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Chapter 37: Drugs Used to Treat Thyroid Disease
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Q1) Which clinical symptoms would the nurse observe in a patient with thyrotoxicosis? (Select all that apply.)
A) Decreased metabolic rate
B) Decreased heart rate
C) Decreased body temperature
D) Muscle tremors
E) Restlessness
F) Anxiety
G) Sweating
Q2) A patient recently completed radiation treatment for throat cancer and presents to the health care provider's office with symptoms indicating possible hypothyroidism. Which symptoms would most likely be exhibited and/or reported? (Select all that apply.)
A) Inability to sleep
B) Weight gain
C) Lethargy
D) Nervousness
E) Cold intolerance
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Chapter 38: Corticosteroids
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Q1) A patient on a high dosage of corticosteroids over a period of time may develop which type of psychiatric complication?
A) Lethargy
B) Psychotic behaviors
C) Manic phases
D) Anxiety attacks
Q2) Which is a function of glucocorticoids? (Select all that apply.)
A) Maintain fluid and electrolyte balance
B) Have anti-inflammatory activities
C) Regulate protein, carbohydrate, and fat metabolism
D) Provide relief of rheumatoid arthritis
E) Include aldosterone
Q3) What is the rationale for administering glucocorticoid therapy as an adjunct to chemotherapeutic agents?
A) Assists with pain control
B) Raises blood sugar to meet the increased metabolic needs
C) Produces immunosuppression effects
D) Reduces mucositis
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Chapter 39: Gonadal Hormones
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Q1) What is progestin therapy used for? (Select all that apply.)
A) Contraception
B) Endometriosis
C) Amenorrhea
D) Abnormal uterine bleeding
E) Cancer
Q2) What is the rationale for using an androgen as part of breast cancer treatment?
A) For maintenance of fat stores
B) To promote nutrition
C) To prevent wasting associated secondary to cancer growth
D) For palliative treatment to suppress cancer cell growth
Q3) The nurse is teaching a young woman about birth control pills. For which situation will the patient need to seek immediate follow-up with the health care provider?
A) Breakthrough bleeding
B) Nausea
C) Missed dose
D) Light menstrual flow
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Chapter 40: Drugs Used in Obstetrics
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Sample Questions
Q1) Which will the nurse include when teaching a postpartum patient about expected adverse effects of Rh<sub>o</sub>(D) immune globulin? (Select all that apply.)
A) Nausea
B) Constipation
C) Fever
D) Insomnia
E) Aches
F) Diarrhea
G) Anorexia
Q2) A patient at 33 weeks' gestation is admitted to the obstetric unit in active labor with symptoms associated with pregnancy-induced hypertension (PIH). Which actions will the nurse implement? (Select all that apply.)
A) Vital signs hourly
B) Administration of IV pitocin
C) Administration of magnesium sulfate IV
D) Fetal stress test
E) Assessment of deep tendon reflexes
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43
Chapter 41: Drugs Used in Mens and Womens Health
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Sample Questions
Q1) The nurse is teaching a patient beginning therapy with dutasteride (Avodart). How long will it take before the patient can expect results?
A) 24 hours
B) 2 weeks
C) 1 month
D) 6 months
Q2) The health care provider has instructed a patient to use over-the-counter miconazole (Monistat) cream to treat her vaginal yeast infection. Which information is important to include in patient education? (Select all that apply.)
A) Wash the genital area thoroughly before inserting the vaginal cream.
B) Wash the applicator before usage.
C) Wear a minipad to catch remaining discharge following vaginal administration.
D) Wash hands before and after administration.
E) The sexual partner may require treatment as well.
Q3) What is the mechanism whereby estrogen functions as a contraceptive?
A) Inhibiting LH, blocking release of ovum from a follicle
B) Thinning cervical mucus, which inhibits sperm migration
C) Trapping the ovum in the endometrial wall, preventing its growth
D) Blocking FSH, thereby preventing release of ovum
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Page 44
Chapter 42: Drugs Used to Treat Disorders of the Urinary System
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Sample Questions
Q1) How often is fosfomycin (Monurol) usually administered when used in the treatment of urinary tract infections?
A) In a one-time dose
B) Once per day
C) Once per week
D) Monthly
Q2) A patient is complaining of moderate bladder pain and spasms secondary to a urinary tract infection. Which drug would assist in relieving symptoms?
A) Tolterodine (Detrol)
B) Nitrofurantoin (Furadantin)
C) Phenazopyridine hydrochloride (Pyridium)
D) Oxybutynin chloride (Ditropan)
Q3) The nurse is teaching a patient about the anticholinergic agent prescribed for urinary retention. Which statement by the patient indicates a need for further teaching?
A) "I will chew gum to relieve dry mouth."
B) "I will limit my fluid intake."
C) "I will eat fresh fruits."
D) "I will not drive if I develop blurred vision."
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Chapter 43: Drugs Used to Treat Glaucoma and Other Eye Disorders
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Q1) A factory worker had a chemical inadvertently splashed into his right eye. An eyewash was used at the work site. Which nursing assessments are important to include? (Select all that apply.)
A) Visual acuity
B) Presence of pain, blurred or halo vision, or lack of vision
C) Type of chemical
D) Presence of nystagmus
E) Presence of contacts or use of eyeglasses
Q2) Which medication is used to produce miosis following a diagnostic procedure?
A)Pilocarpine (Pilocar)
B)Mannitol (Osmitrol)
C)Atropine (Isopto-Atropine)
D)Epinephrine (EpiPen)
Q3) Which statement is true about aqueous humor? (Select all that apply.)
A) Bathes and feeds the lens, posterior surface of the cornea, and iris
B) Maintains the iris color
C) Drains out of the eye through drainage channels located near the junction of the cornea and sclera
D) Manufactures fluid for tear production
E) Flows out of the canal of Schlemm into the venous system of the eye
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Chapter 44: Drugs Used for Cancer Treatment
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Sample Questions
Q1) When are cancer cells most sensitive to chemotherapy?
A) Resting phases
B) Rapid division
C) Remission intervals
D) Slow replication
Q2) The nurse is educating a patient with cancer about combination chemotherapy. Which is an accurate statement?
A) "Combination chemotherapy is the administration of an antineoplastic drug that will be toxic during a specific phase of cellular growth."
B) "Combination chemotherapy is the administration of an antineoplastic drug that is active throughout the cell cycle."
C) "Combination chemotherapy is the administration of antineoplastic drugs that change the way the body responds to cancer or strengthens the immune system."
D) "Combination chemotherapy is the administration of antineoplastic drugs, which results in cell death during different phases of the cell cycle."
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Chapter 45: Drugs Used to Treat the Muscular System
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Q1) Which symptoms will be most important for the nurse to assess for early signs of respiratory distress in the patient who has been given a neuromuscular blocking agent?
A) Nasal flaring and retraction of intercostal muscles
B) Dyspnea, increased respiratory rate, and cyanosis
C) Restlessness, anxiety, and lethargy
D) Pallor, stridor, and diaphoresis
Q2) A patient taking antipsychotic medication for schizophrenia is admitted with a temperature of 106S1U1P1\(\circ\)S1S1P0 F. The admitting diagnosis is neuroleptic malignant syndrome secondary to antipsychotic medication. Which drug is indicated in treatment of this condition?
A) Edrophonium (Tensilon)
B) Dantrolene (Dantrium)
C) Baclofen (Lioresal)
D) Metaxolone (Skelaxin)
Q3) Which common adverse effects occur with neuromuscular blocking agents?
A) Fever
B) Flushing
C) Nausea
D) Ataxia
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Page 48
Chapter 46: Antimicrobial Agents
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Q1) Which drug is incompatible with heparin?
A) Gentamicin
B) Ampicillin (Unasyn)
C) Ticarcillin (Timentin)
D) Ciprofloxacin (Cipro)
Q2) Which drugs may reach toxic blood levels if administered with macrolide antibiotics? (Select all that apply.)
A) Benzodiazepines
B) Digoxin
C) NSAIDs
D) HMG-CoA reductase inhibitors
E) Diuretics
F) Theophylline
Q3) Which conditions may occur with the administration of broad-spectrum antibiotics over an extended period of time?
A) Cross-sensitivity
B) Immunosuppression
C) Secondary infection
D) Immunity
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Chapter 47: Nutrition
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Sample Questions
Q1) Which food is a good source of vitamin A?
A) Sweet potatoes
B) Apples
C) Bananas
D) Whole-grain bread
Q2) A patient is receiving continuous tube feedings at 100 mL/hr. At 1400, the nurse determines that there is 175 mL of residual volume. Which action will the nurse take?
A) Continue the feedings as ordered.
B) Reduce the feeding by 50%.
C) Stop the feeding and notify the health care provider.
D) Aspirate and dispose of the residual and restart the feeding.
Q3) Which dietary fats are cardioprotective?
A) Monounsaturated
B) Polyunsaturated
C) Saturated
D) Trans
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Chapter 48: Herbal and Dietary Supplement Therapy
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Q1) Which herb is used to stimulate the innate immune system?
A) Aloe
B) Echinacea
C) Chamomile
D) Ginger
Q2) Which is a therapeutic effect of valerian?
A) Lower HDLs and raise LDLs
B) Prevent infection
C) Promote relaxation and sleep
D) Elevate mood
Q3) Which statement about dietary supplements is true?
A) Dietary supplements are considered safe and effective.
B) Dietary supplements have not been tested for safety or efficacy.
C) There are no serious adverse effects to taking dietary supplements.
D) Dietary supplements have full FDA and USP approval.
Q4) Which dietary supplement is used to treat benign prostatic hyperplasia?
A) Ginkgo
B) Ephedra
C) Garlic
D) Saw palmetto
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Chapter 49: Substance Abuse
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Q1) A nurse working the night shift suspects that a colleague is abusing alcohol. Which action by the nurse is most important?
A) "Good faith" reporting is unfaithful to a colleague.
B) Reporting will result in loss of the colleague's license.
C) It is not of concern, and the nurse won't be penalized for refusing to get involved.
D) State guidelines may mandate to report substance abuse.
Q2) What does a urinalysis that is positive for the drug tested indicate?
A) It indicates illegal drug use.
B) It verifies drug dependency.
C) It is a violation of the individual's constitutional rights.
D) It verifies whether the drug is present in the specimen.
Q3) A patient admitted 48 hours ago has a diagnosis of GI bleeding and is receiving IV hydration and transfusions. When making rounds, the nurse observes the patient to be having a tonic-clonic seizure. What may be the cause of the seizure?
A) Low blood counts secondary to bleeding
B) Alcohol withdrawal
C) Alkalosis
D) Inadequate nutrition
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Chapter 50: Miscellaneous Agents
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Q1) The nurse is providing information to a patient with chronic gout arthritis who is prescribed probenecid. Which information by the nurse is accurate regarding the action of this drug?
A) It prevents uric acid crystal formation.
B) It promotes uric acid excretion.
C) It provides analgesia.
D) It treats acute gout attacks.
Q2) The nurse receives an order to administer colchicine 0.6 mg every 1 to 2 hours until the patient exhibits adverse effects. The nurse will monitor for which adverse effect?
A) Diminished fever
B) Diarrhea or nausea
C) Increased urination
D) Decrease in erythema
Q3) Why is lactulose administered to a patient with end-stage liver disease and encephalopathy?
A) To increase daily urine output
B) To relieve constipation
C) To reduce formation of ammonia in the gut
D) To maintain electrolyte values within normal limits
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