PHARM 245 FINAL EXAM| QUESTIONS AND ANSWERS
WITH VERIFIED RATIONALES | FALL 2025/2026 UPDATE |
100% CORRECT.
1. 1) A nurse is caring for a client with hyperparathyroidism and notes that the
client's serum calcium level is 13 mg/dL. Which medication should the nurse
prepare to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D: 3.
Calcitonin (Miacalcin) Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
2. 2.) Oral iron supplements are prescribed for a 6-year-old child with iron
deficiency anemia. The nurse instructs the mother to administer the iron with
which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice: 4.
Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be
instructed to administer the medication with a citrus fruit or a juice that is high
in vitamin C. Milk may affect absorption of the iron. Water will not assist in
absorption. Orange juice contains a greater amount of vitamin C than apple juice.
,3. 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of the following would indicate the
presence of systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased
respirations: 1.
Tinnitus Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity
(salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and
psychological disturbances. Constipation and diarrhea are not associated with
salicylism.
4. 4.) The camp nurse asks the children preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the children that chemical sunscreens are
most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun: 4. At least
30 minutes before exposure to the sun Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied
after swimming or sweating.
5. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn
injury. When applying the medication, the client complains of local discomfort
and burning. Which of the following is the most appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site: 3.
,Informing the client that this is normal Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The
client should be informed that the medication will cause local discomfort and
burning and that this is a normal reaction; therefore options 1, 2, and 4 are
incorrect
, 6. 6.) The burn client is receiving treatments of topical mafenide acetate
(Sulfamylon) to the site of injury. The nurse monitors the client, knowing that
which of the following indicates that a systemic effect has occurred?
1. Hyperventilation
2. Elevated blood pressure
3. Local pain at the burn site
4. Local rash at the burn site:
1.Hyperventilation Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal
excretion of acid, thereby causing acidosis. Clients receiving this treatment
should be monitored for signs of an acid-base imbalance (hyperventilation). If
this occurs, the medication should be discontinued for 1 to 2 days. Options 3 and
4 describe local rather than systemic effects. An elevated blood pressure may be
expected from the pain that occurs with a burn injury.
7. 7.) Isotretinoin is prescribed for a client with severe acne. Before the
administration of this medication, the nurse anticipates that which laboratory test
will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count: 2.
Triglyceride level Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
8. 8.) A client with severe acne is seen in the clinic and the health care provider
(HCP) prescribes isotretinoin. The nurse reviews the client's medication record
and would contact the (HCP) if the client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
WITH VERIFIED RATIONALES | FALL 2025/2026 UPDATE |
100% CORRECT.
1. 1) A nurse is caring for a client with hyperparathyroidism and notes that the
client's serum calcium level is 13 mg/dL. Which medication should the nurse
prepare to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D: 3.
Calcitonin (Miacalcin) Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for
the treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
2. 2.) Oral iron supplements are prescribed for a 6-year-old child with iron
deficiency anemia. The nurse instructs the mother to administer the iron with
which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice: 4.
Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be
instructed to administer the medication with a citrus fruit or a juice that is high
in vitamin C. Milk may affect absorption of the iron. Water will not assist in
absorption. Orange juice contains a greater amount of vitamin C than apple juice.
,3. 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of the following would indicate the
presence of systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased
respirations: 1.
Tinnitus Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity
(salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and
psychological disturbances. Constipation and diarrhea are not associated with
salicylism.
4. 4.) The camp nurse asks the children preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the children that chemical sunscreens are
most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun: 4. At least
30 minutes before exposure to the sun Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied
after swimming or sweating.
5. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn
injury. When applying the medication, the client complains of local discomfort
and burning. Which of the following is the most appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site: 3.
,Informing the client that this is normal Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The
client should be informed that the medication will cause local discomfort and
burning and that this is a normal reaction; therefore options 1, 2, and 4 are
incorrect
, 6. 6.) The burn client is receiving treatments of topical mafenide acetate
(Sulfamylon) to the site of injury. The nurse monitors the client, knowing that
which of the following indicates that a systemic effect has occurred?
1. Hyperventilation
2. Elevated blood pressure
3. Local pain at the burn site
4. Local rash at the burn site:
1.Hyperventilation Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal
excretion of acid, thereby causing acidosis. Clients receiving this treatment
should be monitored for signs of an acid-base imbalance (hyperventilation). If
this occurs, the medication should be discontinued for 1 to 2 days. Options 3 and
4 describe local rather than systemic effects. An elevated blood pressure may be
expected from the pain that occurs with a burn injury.
7. 7.) Isotretinoin is prescribed for a client with severe acne. Before the
administration of this medication, the nurse anticipates that which laboratory test
will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count: 2.
Triglyceride level Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
8. 8.) A client with severe acne is seen in the clinic and the health care provider
(HCP) prescribes isotretinoin. The nurse reviews the client's medication record
and would contact the (HCP) if the client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
