1
Pharm quiz assignment answers
1. ID: 311018725
Which route should the nurse clarify with the healthcare provider prior to
administering a drug with a high first-pass effect?
A. Intravenous.
B. Buccal.
C. Sublingual.
D. Oral. Correct
The first-pass effect occurs when hepatic metabolism decreases the
bioavailability of a drug. Oral (A) forms of medications are processed through the
GI tract, absorbed through the small intestines, and undergo the first-pass effect
in the liver before the drug reaches the intended site of action. (B, C, and D)
bypass the hepatic metabolism and are not affected by the first-pass effect.
Awarded 5.0 points out of 5.0 possible points.
2. ID: 310951980
A client calls the clinic and states that she forgot to take her oral contraceptives for the past two days.
Which instruction is best for the nurse to provide to this client?
A. Quit the pills for this cycle, use an alternate method of contraception, and resume pills
on the fifth day of menstruation.
B. Take 4 pills now and use an alternate method of contraception for the rest of this
cycle.
C. Take 2 pills a day for 2 days and use an alternate method of contraception for 7
days. Correct
D. Take one extra pill per day for the rest of this cycle, then resume taking pills as usual
next cycle.
If two pills are missed the client should implement (A). If three pills are missed,
the client should implement (B). The woman who misses three or more days also
has the option of stopping the pills in this cycle pack and starting a new pack on
the same day. A backup method of contraception should be used for 7 days. (C
and D) provide incorrect instructions.
3. ID: 310944033
The healthcare provider prescribes a medication for an older adult client who is
complaining of insomnia, and instructs the client to return in two weeks. The
nurse should question which prescription?
A. Temazepam (Restoril) 7.5 milligrams orally at bedtime.
B. Eszopiclone (Lunesta) 10 milligrams orally at bedtime. Correct
C. Ramelteon (Rozerem) 8 milligrams orally at bedtime.
D. Zolpidem (Ambien) 10 milligrams orally at bedtime.
,2
The dosage range for eszopiclone (Lunesta) is 1 to 3 milligrams daily at bedtime,
so the dosage for (B) is too high. (A, C, and D) are within a safe dosage range and
are not contraindicated for use in the elderly.
4. ID: 310946610
A client with chronic kidney disease (CKD) and severe anemia refuses blood
transfusions. The healthcare provider prescribes epoetin alfa. Which action
should the nurse explain to the client about the medication's therapeutic
response?
A. Stimulates erythropoiesis in the bone marrow to increase circulating
erythrocytes. Correct
B. Accelerates neutrophil production, maturation, and activation.
C. Increases production and maturation of granulocytes and
macrophages.
D. Activates the immune system with development of T and B cells and
natural killer cells.
Epoetin alfa is a biological response modifier that is used to stimulate the
formation of red blood cells (C). (A) describes agents, such as filgrastim, used to
decrease the risk for infection in clients with chemotherapy-induced neutropenia.
Immunomodulators, a subtype of biologic response modifiers, such as interferon,
provide a specified action in the immune system (B) used in chemotherapeutic
protocols. (D) specifies the therapeutic response of agents, such as
sargramostim, which also inhibits neutrophil migration and is primarily used to
accelerate myeloid recovery during bone marrow transplantation. Category:
Pharmacology
5. ID: 311002959
Which statement by a client warrants further instruction by the nurse about the
changing insulin needs of a diabetic client during pregnancy?
A. I will increase my insulin dosage by 5 units each month during the
first trimester.Correct
B. Breastfeeding will decrease my insulin needs to lower than my
prepregnancy levels.
C. Insulin dosage will likely need to be increased during the second and
third trimesters. Incorrect
D. Episodes of hypoglycemia are more likely to occur during the first 3
months.
Insulin needs during pregnancy are determined individually according to the
client's glucose levels. Insulin needs in the first trimester may actually decrease,
so (B) indicates the need for reteaching. (A, C, and D) are correct statements. (A)
helps explains why insulin needs may actually decrease in the first trimester.
, 3
Insulin resistance begins as early as 14- to 16-weeks gestation (C) and continues
to rise until it stabilizes during the last few weeks of pregnancy. Insulin needs
after birth are lower once the placenta is delivered and the source of insulin
resistance is gone. Breastfeeding (D) lowers circulating blood glucose.
6. ID: 310965985
A client receives a new prescription for ciprofloxacin (Cipro), a synthetic quinolone. When teaching about
this drug, which information in the client's history requires special emphasis by the nurse?
A. Snacks on dairy products such as yogurt or ice cream.
B. Works twenty hours a week as a lifeguard at the local pool. Correct
C. Previously had a mild allergic reaction to a cephalosporin.
D. Consumes alcoholic drinks occasionally on the weekends.
Cipro can cause both dizziness and photosensitivity. Since the client works as a
lifeguard outdoors (D), measures related to these adverse effects should be
addressed. Dairy products (A) do not impact the effectiveness of Cipro. There is
no cross-sensitivity between quinolones and cephalosporins (B). Although
avoiding alcohol consumption is commonly recommended with many prescription
drugs, (C) does not affect the actions of Cipro.
7. ID: 310944037
Which common side effect should the nurse alert a female client about when
medroxyprogesterone (Depo-Provera) is prescribed?
A. Leg or calf pain. Incorrect
B. Jaundice during the first 3 weeks of administration.
C. Headaches or visual changes.
D. Vaginal bleeding after discontinuing the medication. Correct
Approximately 3 to 7 days after the last cyclic dose of medroxyprogesterone, a
female client may experience withdrawal vaginal bleeding (C). (A, B, and D) are
not common side effects of hormonal therapy and may indicate a serious adverse
reaction.
8. ID: 310993907
When assessing a client prior to the administration of digoxin (Lanoxin), which
data is most important for the nurse to consider?
A. Bilateral lower extremity dependent rubor.
B. Presence of a grade 2 murmur.
C. Nailbed capillary refill of 5 seconds.
D. Irregular apical pulse with a rate of 87. Correct
The action of digoxin is to slow the heart rate and strengthen the force of
contraction, so it is essential for the nurse to ensure that the apical pulse (C) is
within determined parameters prior to administration. (A, B, and D) are unlikely
to influence the nurse's decision regarding the administration of digoxin.
Pharm quiz assignment answers
1. ID: 311018725
Which route should the nurse clarify with the healthcare provider prior to
administering a drug with a high first-pass effect?
A. Intravenous.
B. Buccal.
C. Sublingual.
D. Oral. Correct
The first-pass effect occurs when hepatic metabolism decreases the
bioavailability of a drug. Oral (A) forms of medications are processed through the
GI tract, absorbed through the small intestines, and undergo the first-pass effect
in the liver before the drug reaches the intended site of action. (B, C, and D)
bypass the hepatic metabolism and are not affected by the first-pass effect.
Awarded 5.0 points out of 5.0 possible points.
2. ID: 310951980
A client calls the clinic and states that she forgot to take her oral contraceptives for the past two days.
Which instruction is best for the nurse to provide to this client?
A. Quit the pills for this cycle, use an alternate method of contraception, and resume pills
on the fifth day of menstruation.
B. Take 4 pills now and use an alternate method of contraception for the rest of this
cycle.
C. Take 2 pills a day for 2 days and use an alternate method of contraception for 7
days. Correct
D. Take one extra pill per day for the rest of this cycle, then resume taking pills as usual
next cycle.
If two pills are missed the client should implement (A). If three pills are missed,
the client should implement (B). The woman who misses three or more days also
has the option of stopping the pills in this cycle pack and starting a new pack on
the same day. A backup method of contraception should be used for 7 days. (C
and D) provide incorrect instructions.
3. ID: 310944033
The healthcare provider prescribes a medication for an older adult client who is
complaining of insomnia, and instructs the client to return in two weeks. The
nurse should question which prescription?
A. Temazepam (Restoril) 7.5 milligrams orally at bedtime.
B. Eszopiclone (Lunesta) 10 milligrams orally at bedtime. Correct
C. Ramelteon (Rozerem) 8 milligrams orally at bedtime.
D. Zolpidem (Ambien) 10 milligrams orally at bedtime.
,2
The dosage range for eszopiclone (Lunesta) is 1 to 3 milligrams daily at bedtime,
so the dosage for (B) is too high. (A, C, and D) are within a safe dosage range and
are not contraindicated for use in the elderly.
4. ID: 310946610
A client with chronic kidney disease (CKD) and severe anemia refuses blood
transfusions. The healthcare provider prescribes epoetin alfa. Which action
should the nurse explain to the client about the medication's therapeutic
response?
A. Stimulates erythropoiesis in the bone marrow to increase circulating
erythrocytes. Correct
B. Accelerates neutrophil production, maturation, and activation.
C. Increases production and maturation of granulocytes and
macrophages.
D. Activates the immune system with development of T and B cells and
natural killer cells.
Epoetin alfa is a biological response modifier that is used to stimulate the
formation of red blood cells (C). (A) describes agents, such as filgrastim, used to
decrease the risk for infection in clients with chemotherapy-induced neutropenia.
Immunomodulators, a subtype of biologic response modifiers, such as interferon,
provide a specified action in the immune system (B) used in chemotherapeutic
protocols. (D) specifies the therapeutic response of agents, such as
sargramostim, which also inhibits neutrophil migration and is primarily used to
accelerate myeloid recovery during bone marrow transplantation. Category:
Pharmacology
5. ID: 311002959
Which statement by a client warrants further instruction by the nurse about the
changing insulin needs of a diabetic client during pregnancy?
A. I will increase my insulin dosage by 5 units each month during the
first trimester.Correct
B. Breastfeeding will decrease my insulin needs to lower than my
prepregnancy levels.
C. Insulin dosage will likely need to be increased during the second and
third trimesters. Incorrect
D. Episodes of hypoglycemia are more likely to occur during the first 3
months.
Insulin needs during pregnancy are determined individually according to the
client's glucose levels. Insulin needs in the first trimester may actually decrease,
so (B) indicates the need for reteaching. (A, C, and D) are correct statements. (A)
helps explains why insulin needs may actually decrease in the first trimester.
, 3
Insulin resistance begins as early as 14- to 16-weeks gestation (C) and continues
to rise until it stabilizes during the last few weeks of pregnancy. Insulin needs
after birth are lower once the placenta is delivered and the source of insulin
resistance is gone. Breastfeeding (D) lowers circulating blood glucose.
6. ID: 310965985
A client receives a new prescription for ciprofloxacin (Cipro), a synthetic quinolone. When teaching about
this drug, which information in the client's history requires special emphasis by the nurse?
A. Snacks on dairy products such as yogurt or ice cream.
B. Works twenty hours a week as a lifeguard at the local pool. Correct
C. Previously had a mild allergic reaction to a cephalosporin.
D. Consumes alcoholic drinks occasionally on the weekends.
Cipro can cause both dizziness and photosensitivity. Since the client works as a
lifeguard outdoors (D), measures related to these adverse effects should be
addressed. Dairy products (A) do not impact the effectiveness of Cipro. There is
no cross-sensitivity between quinolones and cephalosporins (B). Although
avoiding alcohol consumption is commonly recommended with many prescription
drugs, (C) does not affect the actions of Cipro.
7. ID: 310944037
Which common side effect should the nurse alert a female client about when
medroxyprogesterone (Depo-Provera) is prescribed?
A. Leg or calf pain. Incorrect
B. Jaundice during the first 3 weeks of administration.
C. Headaches or visual changes.
D. Vaginal bleeding after discontinuing the medication. Correct
Approximately 3 to 7 days after the last cyclic dose of medroxyprogesterone, a
female client may experience withdrawal vaginal bleeding (C). (A, B, and D) are
not common side effects of hormonal therapy and may indicate a serious adverse
reaction.
8. ID: 310993907
When assessing a client prior to the administration of digoxin (Lanoxin), which
data is most important for the nurse to consider?
A. Bilateral lower extremity dependent rubor.
B. Presence of a grade 2 murmur.
C. Nailbed capillary refill of 5 seconds.
D. Irregular apical pulse with a rate of 87. Correct
The action of digoxin is to slow the heart rate and strengthen the force of
contraction, so it is essential for the nurse to ensure that the apical pulse (C) is
within determined parameters prior to administration. (A, B, and D) are unlikely
to influence the nurse's decision regarding the administration of digoxin.
