PHARM EXAM 1 PRACTICE QUESTIONS
What nursing intervention is appropriate for a 70-year-old female patient .1
?receiving lithium
.A) Instruct the patient to use barrier contraceptives
.B) Monitor blood glucose levels
.C) Monitor fluid and sodium intake
.D) Encourage the patient to check daily for weight loss
Ans:C; Feedback: Older patients, and especially those with renal impairment, should be
encouraged to maintain adequate hydration and salt intake. Decreased dosages may also be
necessary with the elderly. A 70-year-old patient would not be concerned about the use of
contraceptives. These drugs alone do not affect glucose levels. Weight loss is usually not
.associated with lithium use
A nurse is caring for a patient who is taking lithium for mania. The nurses .2
assessment includes a notation of a lithium serum level of 2.4 mEq/L. The nurse
?anticipates seeing what
A) Fine tremors of both hands
B) Slurred speech
C) Clonic movements
D) Nausea and vomiting
Ans:C; Feedback: Serum levels of 2 to 2.5 mEq/L may produce ataxia, clonic movements,
possible seizures, and hypotension. Fine hand tremors, slurred speech, and nausea and
.vomiting are indicative of lithium levels less than 1.5 mEq/L
The nurse administers chlorpromazine intramuscularly to the preoperative .3
patient who is extremely anxious about surgery in the morning. What priority
?teaching point will the nurse provide this patient
.A) Remain recumbent for at least 30 minutes after the injection
.B) Do not eat for 1 hour after the drug is administered
.C) Encourage fluids with the goal of 3,000 mL/d
.D) Avoid eating avocados and oranges when taking this medication
Ans:A; Feedback: When giving a parenteral form of an antipsychotic, the patient should
remain recumbent to decrease the risk of injury if orthostatic hypotension occurs. Eating
after drug injection should not interfere with the drugs absorption and although adequate
hydration should be maintained there is no need to increase fluid intake. Avocados and
.oranges are not contraindicated in patients receiving this medication
The nurse is presenting an in-service at a childrens unit on hyperactivity. The .4
nurse is told that a 6-year-old on the unit is being treated with methylphenidate
(Ritalin), an amphetamine. The presenting nurse talks about discharge teaching
?for this patient and the importance of monitoring what
, A) Long bone growth
B) Visual acuity
C) Weight and complete blood count
D) Urea and nitrogen levels
Ans:C; Feedback: Methylphenidate is associated with weight loss, bone marrow suppression,
and cardiac arrhythmias. Weight, blood count, and cardiac function should be monitored
regularly. The drug is not associated with renal dysfunction, visual changes, or growth
retardation, so those values would not need to be regularly evaluated as part of drug
.therapy
The nurse is caring for a patient taking an oral neuroleptic medication, .5
?haloperidol. What is the nurses priority assessment to monitor for
A) Urge incontinence
B) Orthostatic hypotension
C) Bradycardia
D) Tardive dyskinesia
Ans:D; Feedback: The nurse would monitor for and teach the patient and family about
tardive dyskinesias because it is such a common adverse effect with continued use of the
drug. Oral neuroleptic agents do not cause urge incontinence, orthostatic hypotension, or
.bradycardia
A psychotic patient is admitted through the emergency department. The .6
physician has ordered chlorpromazine (Thorazine) 25 mg intramuscularly. After
?administration of the medication, what is the nurses priority to evaluate
A) The patients ability to ambulate
B) Return of the patients appetite
C) A decrease in psychotic symptoms
D) Blood pressure and pulse
Ans:C; Feedback: The nurse will evaluate the effectiveness of the drug in diminishing
psychotic symptoms because this is the purpose of administering the drug. Monitoring blood
pressure, pulse, and appetite is part of all patient care but is not the priority evaluation
criterion for this patient. The ability to ambulate and maintain adequate nutrition would be
.assessed but is not the priority evaluation for this patient
A patient diagnosed with bipolar disorder is to be discharged home in 48 hours. .7
The nurse has completed patient teaching regarding the use of lithium. What
?statement by the patient indicates an understanding of their responsibility
.A) I will increase my salt intake
.B) I will increase my fluid intake
.C) I will decrease my salt intake
.D) I will decrease my fluid intake
Ans:B; Feedback: To maintain a therapeutic lithium level, the patient must increase fluids. A
decrease in consumption of fluids can lead to toxicity. An increase in salt intake can lead to
What nursing intervention is appropriate for a 70-year-old female patient .1
?receiving lithium
.A) Instruct the patient to use barrier contraceptives
.B) Monitor blood glucose levels
.C) Monitor fluid and sodium intake
.D) Encourage the patient to check daily for weight loss
Ans:C; Feedback: Older patients, and especially those with renal impairment, should be
encouraged to maintain adequate hydration and salt intake. Decreased dosages may also be
necessary with the elderly. A 70-year-old patient would not be concerned about the use of
contraceptives. These drugs alone do not affect glucose levels. Weight loss is usually not
.associated with lithium use
A nurse is caring for a patient who is taking lithium for mania. The nurses .2
assessment includes a notation of a lithium serum level of 2.4 mEq/L. The nurse
?anticipates seeing what
A) Fine tremors of both hands
B) Slurred speech
C) Clonic movements
D) Nausea and vomiting
Ans:C; Feedback: Serum levels of 2 to 2.5 mEq/L may produce ataxia, clonic movements,
possible seizures, and hypotension. Fine hand tremors, slurred speech, and nausea and
.vomiting are indicative of lithium levels less than 1.5 mEq/L
The nurse administers chlorpromazine intramuscularly to the preoperative .3
patient who is extremely anxious about surgery in the morning. What priority
?teaching point will the nurse provide this patient
.A) Remain recumbent for at least 30 minutes after the injection
.B) Do not eat for 1 hour after the drug is administered
.C) Encourage fluids with the goal of 3,000 mL/d
.D) Avoid eating avocados and oranges when taking this medication
Ans:A; Feedback: When giving a parenteral form of an antipsychotic, the patient should
remain recumbent to decrease the risk of injury if orthostatic hypotension occurs. Eating
after drug injection should not interfere with the drugs absorption and although adequate
hydration should be maintained there is no need to increase fluid intake. Avocados and
.oranges are not contraindicated in patients receiving this medication
The nurse is presenting an in-service at a childrens unit on hyperactivity. The .4
nurse is told that a 6-year-old on the unit is being treated with methylphenidate
(Ritalin), an amphetamine. The presenting nurse talks about discharge teaching
?for this patient and the importance of monitoring what
, A) Long bone growth
B) Visual acuity
C) Weight and complete blood count
D) Urea and nitrogen levels
Ans:C; Feedback: Methylphenidate is associated with weight loss, bone marrow suppression,
and cardiac arrhythmias. Weight, blood count, and cardiac function should be monitored
regularly. The drug is not associated with renal dysfunction, visual changes, or growth
retardation, so those values would not need to be regularly evaluated as part of drug
.therapy
The nurse is caring for a patient taking an oral neuroleptic medication, .5
?haloperidol. What is the nurses priority assessment to monitor for
A) Urge incontinence
B) Orthostatic hypotension
C) Bradycardia
D) Tardive dyskinesia
Ans:D; Feedback: The nurse would monitor for and teach the patient and family about
tardive dyskinesias because it is such a common adverse effect with continued use of the
drug. Oral neuroleptic agents do not cause urge incontinence, orthostatic hypotension, or
.bradycardia
A psychotic patient is admitted through the emergency department. The .6
physician has ordered chlorpromazine (Thorazine) 25 mg intramuscularly. After
?administration of the medication, what is the nurses priority to evaluate
A) The patients ability to ambulate
B) Return of the patients appetite
C) A decrease in psychotic symptoms
D) Blood pressure and pulse
Ans:C; Feedback: The nurse will evaluate the effectiveness of the drug in diminishing
psychotic symptoms because this is the purpose of administering the drug. Monitoring blood
pressure, pulse, and appetite is part of all patient care but is not the priority evaluation
criterion for this patient. The ability to ambulate and maintain adequate nutrition would be
.assessed but is not the priority evaluation for this patient
A patient diagnosed with bipolar disorder is to be discharged home in 48 hours. .7
The nurse has completed patient teaching regarding the use of lithium. What
?statement by the patient indicates an understanding of their responsibility
.A) I will increase my salt intake
.B) I will increase my fluid intake
.C) I will decrease my salt intake
.D) I will decrease my fluid intake
Ans:B; Feedback: To maintain a therapeutic lithium level, the patient must increase fluids. A
decrease in consumption of fluids can lead to toxicity. An increase in salt intake can lead to
