NURS 323
MIDTERM & FINAL EXAM
ACTUAL Questions with Answers
(Nursing Pharmacology Concepts I)
Drexel University
This Document Description:
• This document contains a collection of Verified
questions with accurate Answers.
• It covers core topics assessed in the course and
reflects the actual exam format and question style.
Ideal for exam preparation and concept reinforcement.
, Preview Pages Below
Get the Complete PDF After Purchase
NURS 323 - MIDTERM & FINAL EXAM - ACTUAL Questions with Answers - (Nursing Pharmacol
If you require further clarification
or in need of any study resources,
feel free to Message me.
OPEN FULL ORIGINAL PDF
,Table of Contents
MIDTERM EXAM ................................................................... 2
FINAL EXAM ........................................................................ 15
MIDTERM EXAM
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700.
Which action should the nurse take?
A. Take the patient's blood pressure.
B. Give the patient's PRN dose of insulin.
C. Check the patient's capillary blood sugar.
D. Advise the patient to lie down with the legs elevated.
C. Check the patient's capillary blood sugar.
Rationale:
The patient is exhibiting signs of hypoglycemia. Remember that the peak of NPH insulin
can be 6-14 hours after administration.
A teaching plan for a patient who is taking lispro [Humalog] should include which
instruction by the nurse?
A. "Inject this insulin with your first bite of food, because it is very fast acting."
B. "The duration of action for this insulin is about 8 to 10 hours, so you'll need a
snack."
C. "This insulin needs to be mixed with regular insulin to enhance the effects."
D. "To achieve tight glycemic control, this is the only type of insulin you'll need."
A. "Inject this insulin with your first bite of food, because it is very fast acting."
, patient newly
A patient newly diagnosed
diagnosedwith
withtype
type11diabetes
diabetesasks
asksaanurse,
nurse,"How
"Howdoes
doesinsulin
insulin
normally work
normally work in
in my
mybody?"
body?" The nurse
nurse explains
explainsthat
thatnormal
normalinsulin
insulinhas
haswhich
whichaction
actioninin
the body?
the
A. It stimulates
stimulates the
thepancreas
pancreasto
toreabsorb
reabsorbglucose.
glucose.
B. It promotes
promotes the
the synthesis
synthesisof
ofamino
aminoacids
acidsinto
intoglucose.
glucose.
C. It stimulates
stimulates the
theliver
liverto
toconvert
convertglycogen
glycogento
toglucose.
glucose.
D. It promotes
promotes the
the passage
passageof
ofglucose
glucoseinto
intocells
cellsfor
forenergy.
energy.
D. It promotes
promotes the
the passage
passageof
ofglucose
glucoseinto
intocells
cellsfor
forenergy.
energy.
A patient is
is taking
takingglipizide
glipizide[Glucotrol]
[Glucotrol]and
andaabeta-adrenergic
beta-adrenergicmedication.
medication.AAnurse
nurseisis
teaching hypoglycemia
teaching hypoglycemiaawareness
awarenessand
andshould
shouldwarn
warnthe
thepatient
patientabout
aboutthe presence
the ofof
presence
which symptom?
symptom?
Vomiting
A. Vomiting
B. Muscle cramps
cramps
Tachycardia
C. Tachycardia
D. Chills
Tachycardia
C. Tachycardia
A nurse assesses
assesses aa patient
patientwho
whoisistaking
takingpramlintide
pramlintide[Symlin]
[Symlin]with
withmealtime
mealtimeinsulin.
insulin.
finding requires
Which finding requiresimmediate
immediatefollow-up
follow-upby
bythe
thenurse?
nurse?
A. Skin rash
rash
Sweating
B. Sweating
Itching
C. Itching
D. Pedal edema
edema
B. Sweating
Sweating
Rationale:
Rationale:
Sweating is
Sweating is aa manifestation
manifestationof
ofhypoglycemia,
hypoglycemia,an
anadverse
adversereaction
reactionseen
seenwith
withpramlintide
pramlintide
[Symlin]
Before administering
administeringmetformin
metformin[Glucophage],
[Glucophage],the
thenurse
nurseshould
shouldnotify
notifythe
theprescriber
prescriber
about which
which laboratory
laboratoryvalue?
value?
, Creatinine (Cr)
A. Creatinine (Cr)level
levelof
of2.1
2.1mg/dL
mg/dL
B. Hemoglobin
Hemoglobin (Hgb)
(Hgb)level
levelof
of9.5
9.5gm/dL
gm/dL
C. Sodium
Sodium (Na)
(Na) level
levelof
of131
131mEq/dL
mEq/dL
D. Platelet
Plateletcount
countofof120,000/mm3
120,000/mm3
A. Creatinine
Creatinine (Cr)
(Cr) level
level of
of 2.1
2.1mg/dL
mg/dL
Rationale:
Rationale:
High Creatinine
High Creatininelevels
levelsindicate
indicaterenal
renalimpairment.
impairment.Kidney
Kidneyfunction
functionmust
mustbebeadequate
adequateinin
order for
for metformin
metformin[Glucophage]
[Glucophage]to
towork
work
A nurse caring
caring for
foraapatient
patientwho
whohas
hasdiabetic
diabeticketoacidosis
ketoacidosisrecognizes
recognizeswhich
which
characteristics in
characteristics inthe
thepatient?
patient?(Select
(Selectall
allthat
thatapply.)
apply.)
A. Type 2 diabetes
diabetes
B. Altered fat metabolism
metabolism leading
leadingto
toketones
ketones
C. Arterial
Arterialblood
bloodpH
pHof
of7.35
7.35to
to7.45
7.45
D. Sudden onset, triggered
triggeredby
byacute
acuteillness
illness
Plasma osmolality
E. Plasma osmolalityof
of300
300to
to320
320mOsm/L
mOsm/L
B, D, and
and EE
The nurse knows
knows that
that diuretics
diureticsmostly
mostlyaffect
affectwhich
whichfunction
functionofofthe
thekidneys?
kidneys?
Cleansing and
A. Cleansing and maintenance
maintenanceof
ofextracellular
extracellularfluid
fluidvolume
volume
Maintenance of
B. Maintenance of acid-base
acid-basebalance
balance
Excretion of
C. Excretion of metabolic
metabolicwaste
waste
D. Elimination of foreign
foreign substances
substances
Cleansing and
A. Cleansing and maintenance
maintenanceof
ofextracellular
extracellularfluid
fluidvolume
volume
The nurse plans
plans to
to closely
closely monitor
monitor for
for which
which clinical
clinicalmanifestation
manifestationafter
afteradministering
administering
furosemide [Lasix]?
furosemide [Lasix]?
Decreased pulse
A. Decreased pulse
B. Decreased temperature
temperature
, FINAL EXAM
FINAL EXAM
A patient
A patient with
with deep
deepvein
veinthrombosis
thrombosis receiving
receiving anan intravenous
intravenous (IV)(IV) heparin
heparin
infusionasks
infusion asksthe
thenurse
nursehow
how this
this medication
medication works.
works. What
What is the
is the nurse's
nurse's best best
response?
response?
Heparin prevents
a. Heparin preventsthe
theactivation
activationofofvitamin
vitaminKK and
and thus
thus blocks
blocks synthesis
synthesis of some
of some
clotting factors.
clotting factors.
Heparinsuppresses
b. Heparin suppresses coagulation
coagulation by by helping
helping antithrombin
antithrombin perform
perform its natural
its natural
functions.
functions.
c. Heparin
c. Heparinworks
worksbybyconverting
converting plasminogen
plasminogen to plasmin,
to plasmin, which
which in turn
in turn dissolves
dissolves
clot matrix.
the clot matrix.
Heparininhibits
d. Heparin inhibitsthe
theenzyme
enzymeresponsible
responsible forfor platelet
platelet activation
activation andand aggregation
aggregation
vessels.
within vessels.
Heparin suppresses
b. Heparin suppressescoagulation
coagulationbyby helping
helping antithrombin
antithrombin perform
perform itsits natural
natural functions.
functions.
Rationale:
Rationale:
Heparin is
Heparin isan
ananticoagulant
anticoagulantthat
thatworks
worksbybyhelping
helping antithrombininactivate
antithrombin inactivate thrombin
thrombin and
and
Xa,reducing
factor Xa, reducingthe
theproduction
productionofoffibrin
fibrinand
andthus
thusdecreasing
decreasingthethe formation
formation of of clots.
clots.
The nurseisismonitoring
The nurse monitoringa apatient
patient receiving
receiving a heparin
a heparin infusion
infusion for for
the the treatment
treatment of of
pulmonary embolism.Which
pulmonary embolism. Which assessment
assessment finding
finding most
most likely
likely relates
relates to antoadverse
an adverse
effect of
of heparin?
heparin?
a. Heart rate
rate of
of 60
60beats/min
beats/min
b. Blood
Bloodpressure
pressureofof 160/88
160/88 mmmm
HgHg
c. Discoloredurine
c. Discolored urine
d. Inspiratory
Inspiratorywheezing
wheezing
c. Discoloredurine
c. Discolored urine
Rationale:
Rationale:
The primary
The primaryandandmost
mostserious
seriousadverse
adverse effect
effect of of heparin
heparin is bleeding.
is bleeding. Bleeding
Bleeding can can occur
occur
from any site
site and
andmay
maybebemanifested
manifestedininvarious
various ways,
ways, including
including reduced
reduced blood
blood
pressure, increased
pressure, increasedheart
heartrate,
rate,bruises,
bruises, petechiae,
petechiae, hematomas,
hematomas, redred or black
or black stools,
stools,
cloudy or
cloudy or discolored
discoloredurine,
urine,pelvic
pelvicpain,
pain,headache,
headache, and
and lumbar
lumbar pain.
pain.
,The laboratory
The laboratorycalls
callstotoreport
reporta adrop
dropin in the
the platelet
platelet count
count to 90,000/mm3
to 90,000/mm3 for for
a a
receivingheparin
patient receiving heparinfor forthe
thetreatment
treatmentofofpostoperative
postoperative deep
deep vein
vein
thrombosis.Which
thrombosis. Whichaction
action byby
thethe nurse
nurse is the
is the most
most appropriate?
appropriate?
a. Notify
Notify the
the healthcare
healthcareprovider
providertotodiscuss
discuss thethe reduction
reduction or withdrawal
or withdrawal of of
heparin.
heparin.
b. Call
Callthe
thehealthcare
healthcareprovider
providertoto discuss
discuss increasing
increasing the the heparin
heparin dosedose to achieve
to achieve
a therapeutic
therapeutic level.
level.
c. Obtainvitamin
c. Obtain vitaminKKandandprepare
prepare toto administer
administer it by
it by intramuscular
intramuscular (IM)(IM) injection.
injection.
Observethe
d. Observe thepatient
patientand
andmonitor
monitorthe theactivated
activated partial
partial thromboplastin
thromboplastin timetime
(aPTT)as
(aPTT) asindicated.
indicated.
a. Notify
a. Notify the
the healthcare
healthcareprovider
providertotodiscuss
discuss the
the reduction
reduction oror withdrawal
withdrawal of of heparin.
heparin.
Rationale:
Rationale:
Heparin-inducedthrombocytopenia
Heparin-induced thrombocytopenia(HIT)
(HIT)is is a potential
a potential immune-mediated
immune-mediated adverse
adverse effect
effect
infusionsthat
of heparin infusions thatcan
canprove
provefatal.
fatal.HIT
HIT is is suspected
suspected when
when thethe platelet
platelet counts
counts fall fall
A platelet
significantly. A platelet count
countbelow
below100,000/mm3
100,000/mm3would wouldwarrant
warrant discontinuation
discontinuation of of
thethe
heparin.
heparin.
The nurse
The nurseisisready
readytotobegin
begin a heparin
a heparin infusion
infusion for for a patient
a patient withwith evolving
evolving stroke.
stroke.
The baseline
The baselineactivated
activatedpartial
partialthromboplastin
thromboplastin time
time (aPTT)
(aPTT) is seconds.
is 40 40 seconds.
WhichWhich
aPTTvalue
aPTT valueindicates
indicatesthat
thata a therapeutic
therapeutic dose
dose hashas
beenbeen achieved?
achieved?
50
a. 50
70
b. 70
c. 90
c. 90
110
d. 110
70
b. 70
Rationale:
Rationale:
The therapeutic
The therapeuticlevel
levelofofheparin
heparinisisachieved
achieved when
when thethe aPTT
aPTT reaches
reaches 1.5 to1.5 to 2 times
2 times
Thus,aarange
normal. Thus, rangeofof6060toto8080 seconds
seconds would
would be be appropriate
appropriate for for
thisthis patient.
patient.
The nurseisiscaring
The nurse caringforfor a patient
a patient who
who takes
takes warfarin
warfarin [Coumadin]
[Coumadin] for prevention
for prevention of of
deep veinthrombosis.
deep vein thrombosis.The The patient
patient has
has anan international
international normalized
normalized ratio
ratio (INR)
(INR) of of
1.2. Whichaction
1.2. Which actionbybythe
thenurse
nurseis is most
most appropriate?
appropriate?
a. Administer
Administerintravenous
intravenous(IV)
(IV)push
push protamine
protamine sulfate.
sulfate.
b. Continue
Continuewith
withthe
thecurrent
currentprescription.
prescription.
, NURS 323
MIDTERM & FINAL EXAM
ACTUAL Questions with Answers
(Nursing Pharmacology Concepts I)
Drexel University
This Document Description:
• This document contains a collection of Verified
questions with accurate Answers.
• It covers core topics assessed in the course and
reflects the actual exam format and question style.
Ideal for exam preparation and concept reinforcement.
,Table of Contents
MIDTERM EXAM ................................................................... 2
FINAL EXAM ........................................................................ 15
MIDTERM EXAM
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700.
Which action should the nurse take?
A. Take the patient's blood pressure.
B. Give the patient's PRN dose of insulin.
C. Check the patient's capillary blood sugar.
D. Advise the patient to lie down with the legs elevated.
C. Check the patient's capillary blood sugar.
Rationale:
The patient is exhibiting signs of hypoglycemia. Remember that the peak of NPH insulin
can be 6-14 hours after administration.
A teaching plan for a patient who is taking lispro [Humalog] should include which
instruction by the nurse?
A. "Inject this insulin with your first bite of food, because it is very fast acting."
B. "The duration of action for this insulin is about 8 to 10 hours, so you'll need a
snack."
C. "This insulin needs to be mixed with regular insulin to enhance the effects."
D. "To achieve tight glycemic control, this is the only type of insulin you'll need."
A. "Inject this insulin with your first bite of food, because it is very fast acting."
, A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin
normally work in my body?" The nurse explains that normal insulin has which action in
the body?
A. It stimulates the pancreas to reabsorb glucose.
B. It promotes the synthesis of amino acids into glucose.
C. It stimulates the liver to convert glycogen to glucose.
D. It promotes the passage of glucose into cells for energy.
D. It promotes the passage of glucose into cells for energy.
A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is
teaching hypoglycemia awareness and should warn the patient about the presence of
which symptom?
A. Vomiting
B. Muscle cramps
C. Tachycardia
D. Chills
C. Tachycardia
A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin.
Which finding requires immediate follow-up by the nurse?
A. Skin rash
B. Sweating
C. Itching
D. Pedal edema
B. Sweating
Rationale:
Sweating is a manifestation of hypoglycemia, an adverse reaction seen with pramlintide
[Symlin]
Before administering metformin [Glucophage], the nurse should notify the prescriber
about which laboratory value?
MIDTERM & FINAL EXAM
ACTUAL Questions with Answers
(Nursing Pharmacology Concepts I)
Drexel University
This Document Description:
• This document contains a collection of Verified
questions with accurate Answers.
• It covers core topics assessed in the course and
reflects the actual exam format and question style.
Ideal for exam preparation and concept reinforcement.
, Preview Pages Below
Get the Complete PDF After Purchase
NURS 323 - MIDTERM & FINAL EXAM - ACTUAL Questions with Answers - (Nursing Pharmacol
If you require further clarification
or in need of any study resources,
feel free to Message me.
OPEN FULL ORIGINAL PDF
,Table of Contents
MIDTERM EXAM ................................................................... 2
FINAL EXAM ........................................................................ 15
MIDTERM EXAM
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700.
Which action should the nurse take?
A. Take the patient's blood pressure.
B. Give the patient's PRN dose of insulin.
C. Check the patient's capillary blood sugar.
D. Advise the patient to lie down with the legs elevated.
C. Check the patient's capillary blood sugar.
Rationale:
The patient is exhibiting signs of hypoglycemia. Remember that the peak of NPH insulin
can be 6-14 hours after administration.
A teaching plan for a patient who is taking lispro [Humalog] should include which
instruction by the nurse?
A. "Inject this insulin with your first bite of food, because it is very fast acting."
B. "The duration of action for this insulin is about 8 to 10 hours, so you'll need a
snack."
C. "This insulin needs to be mixed with regular insulin to enhance the effects."
D. "To achieve tight glycemic control, this is the only type of insulin you'll need."
A. "Inject this insulin with your first bite of food, because it is very fast acting."
, patient newly
A patient newly diagnosed
diagnosedwith
withtype
type11diabetes
diabetesasks
asksaanurse,
nurse,"How
"Howdoes
doesinsulin
insulin
normally work
normally work in
in my
mybody?"
body?" The nurse
nurse explains
explainsthat
thatnormal
normalinsulin
insulinhas
haswhich
whichaction
actioninin
the body?
the
A. It stimulates
stimulates the
thepancreas
pancreasto
toreabsorb
reabsorbglucose.
glucose.
B. It promotes
promotes the
the synthesis
synthesisof
ofamino
aminoacids
acidsinto
intoglucose.
glucose.
C. It stimulates
stimulates the
theliver
liverto
toconvert
convertglycogen
glycogento
toglucose.
glucose.
D. It promotes
promotes the
the passage
passageof
ofglucose
glucoseinto
intocells
cellsfor
forenergy.
energy.
D. It promotes
promotes the
the passage
passageof
ofglucose
glucoseinto
intocells
cellsfor
forenergy.
energy.
A patient is
is taking
takingglipizide
glipizide[Glucotrol]
[Glucotrol]and
andaabeta-adrenergic
beta-adrenergicmedication.
medication.AAnurse
nurseisis
teaching hypoglycemia
teaching hypoglycemiaawareness
awarenessand
andshould
shouldwarn
warnthe
thepatient
patientabout
aboutthe presence
the ofof
presence
which symptom?
symptom?
Vomiting
A. Vomiting
B. Muscle cramps
cramps
Tachycardia
C. Tachycardia
D. Chills
Tachycardia
C. Tachycardia
A nurse assesses
assesses aa patient
patientwho
whoisistaking
takingpramlintide
pramlintide[Symlin]
[Symlin]with
withmealtime
mealtimeinsulin.
insulin.
finding requires
Which finding requiresimmediate
immediatefollow-up
follow-upby
bythe
thenurse?
nurse?
A. Skin rash
rash
Sweating
B. Sweating
Itching
C. Itching
D. Pedal edema
edema
B. Sweating
Sweating
Rationale:
Rationale:
Sweating is
Sweating is aa manifestation
manifestationof
ofhypoglycemia,
hypoglycemia,an
anadverse
adversereaction
reactionseen
seenwith
withpramlintide
pramlintide
[Symlin]
Before administering
administeringmetformin
metformin[Glucophage],
[Glucophage],the
thenurse
nurseshould
shouldnotify
notifythe
theprescriber
prescriber
about which
which laboratory
laboratoryvalue?
value?
, Creatinine (Cr)
A. Creatinine (Cr)level
levelof
of2.1
2.1mg/dL
mg/dL
B. Hemoglobin
Hemoglobin (Hgb)
(Hgb)level
levelof
of9.5
9.5gm/dL
gm/dL
C. Sodium
Sodium (Na)
(Na) level
levelof
of131
131mEq/dL
mEq/dL
D. Platelet
Plateletcount
countofof120,000/mm3
120,000/mm3
A. Creatinine
Creatinine (Cr)
(Cr) level
level of
of 2.1
2.1mg/dL
mg/dL
Rationale:
Rationale:
High Creatinine
High Creatininelevels
levelsindicate
indicaterenal
renalimpairment.
impairment.Kidney
Kidneyfunction
functionmust
mustbebeadequate
adequateinin
order for
for metformin
metformin[Glucophage]
[Glucophage]to
towork
work
A nurse caring
caring for
foraapatient
patientwho
whohas
hasdiabetic
diabeticketoacidosis
ketoacidosisrecognizes
recognizeswhich
which
characteristics in
characteristics inthe
thepatient?
patient?(Select
(Selectall
allthat
thatapply.)
apply.)
A. Type 2 diabetes
diabetes
B. Altered fat metabolism
metabolism leading
leadingto
toketones
ketones
C. Arterial
Arterialblood
bloodpH
pHof
of7.35
7.35to
to7.45
7.45
D. Sudden onset, triggered
triggeredby
byacute
acuteillness
illness
Plasma osmolality
E. Plasma osmolalityof
of300
300to
to320
320mOsm/L
mOsm/L
B, D, and
and EE
The nurse knows
knows that
that diuretics
diureticsmostly
mostlyaffect
affectwhich
whichfunction
functionofofthe
thekidneys?
kidneys?
Cleansing and
A. Cleansing and maintenance
maintenanceof
ofextracellular
extracellularfluid
fluidvolume
volume
Maintenance of
B. Maintenance of acid-base
acid-basebalance
balance
Excretion of
C. Excretion of metabolic
metabolicwaste
waste
D. Elimination of foreign
foreign substances
substances
Cleansing and
A. Cleansing and maintenance
maintenanceof
ofextracellular
extracellularfluid
fluidvolume
volume
The nurse plans
plans to
to closely
closely monitor
monitor for
for which
which clinical
clinicalmanifestation
manifestationafter
afteradministering
administering
furosemide [Lasix]?
furosemide [Lasix]?
Decreased pulse
A. Decreased pulse
B. Decreased temperature
temperature
, FINAL EXAM
FINAL EXAM
A patient
A patient with
with deep
deepvein
veinthrombosis
thrombosis receiving
receiving anan intravenous
intravenous (IV)(IV) heparin
heparin
infusionasks
infusion asksthe
thenurse
nursehow
how this
this medication
medication works.
works. What
What is the
is the nurse's
nurse's best best
response?
response?
Heparin prevents
a. Heparin preventsthe
theactivation
activationofofvitamin
vitaminKK and
and thus
thus blocks
blocks synthesis
synthesis of some
of some
clotting factors.
clotting factors.
Heparinsuppresses
b. Heparin suppresses coagulation
coagulation by by helping
helping antithrombin
antithrombin perform
perform its natural
its natural
functions.
functions.
c. Heparin
c. Heparinworks
worksbybyconverting
converting plasminogen
plasminogen to plasmin,
to plasmin, which
which in turn
in turn dissolves
dissolves
clot matrix.
the clot matrix.
Heparininhibits
d. Heparin inhibitsthe
theenzyme
enzymeresponsible
responsible forfor platelet
platelet activation
activation andand aggregation
aggregation
vessels.
within vessels.
Heparin suppresses
b. Heparin suppressescoagulation
coagulationbyby helping
helping antithrombin
antithrombin perform
perform itsits natural
natural functions.
functions.
Rationale:
Rationale:
Heparin is
Heparin isan
ananticoagulant
anticoagulantthat
thatworks
worksbybyhelping
helping antithrombininactivate
antithrombin inactivate thrombin
thrombin and
and
Xa,reducing
factor Xa, reducingthe
theproduction
productionofoffibrin
fibrinand
andthus
thusdecreasing
decreasingthethe formation
formation of of clots.
clots.
The nurseisismonitoring
The nurse monitoringa apatient
patient receiving
receiving a heparin
a heparin infusion
infusion for for
the the treatment
treatment of of
pulmonary embolism.Which
pulmonary embolism. Which assessment
assessment finding
finding most
most likely
likely relates
relates to antoadverse
an adverse
effect of
of heparin?
heparin?
a. Heart rate
rate of
of 60
60beats/min
beats/min
b. Blood
Bloodpressure
pressureofof 160/88
160/88 mmmm
HgHg
c. Discoloredurine
c. Discolored urine
d. Inspiratory
Inspiratorywheezing
wheezing
c. Discoloredurine
c. Discolored urine
Rationale:
Rationale:
The primary
The primaryandandmost
mostserious
seriousadverse
adverse effect
effect of of heparin
heparin is bleeding.
is bleeding. Bleeding
Bleeding can can occur
occur
from any site
site and
andmay
maybebemanifested
manifestedininvarious
various ways,
ways, including
including reduced
reduced blood
blood
pressure, increased
pressure, increasedheart
heartrate,
rate,bruises,
bruises, petechiae,
petechiae, hematomas,
hematomas, redred or black
or black stools,
stools,
cloudy or
cloudy or discolored
discoloredurine,
urine,pelvic
pelvicpain,
pain,headache,
headache, and
and lumbar
lumbar pain.
pain.
,The laboratory
The laboratorycalls
callstotoreport
reporta adrop
dropin in the
the platelet
platelet count
count to 90,000/mm3
to 90,000/mm3 for for
a a
receivingheparin
patient receiving heparinfor forthe
thetreatment
treatmentofofpostoperative
postoperative deep
deep vein
vein
thrombosis.Which
thrombosis. Whichaction
action byby
thethe nurse
nurse is the
is the most
most appropriate?
appropriate?
a. Notify
Notify the
the healthcare
healthcareprovider
providertotodiscuss
discuss thethe reduction
reduction or withdrawal
or withdrawal of of
heparin.
heparin.
b. Call
Callthe
thehealthcare
healthcareprovider
providertoto discuss
discuss increasing
increasing the the heparin
heparin dosedose to achieve
to achieve
a therapeutic
therapeutic level.
level.
c. Obtainvitamin
c. Obtain vitaminKKandandprepare
prepare toto administer
administer it by
it by intramuscular
intramuscular (IM)(IM) injection.
injection.
Observethe
d. Observe thepatient
patientand
andmonitor
monitorthe theactivated
activated partial
partial thromboplastin
thromboplastin timetime
(aPTT)as
(aPTT) asindicated.
indicated.
a. Notify
a. Notify the
the healthcare
healthcareprovider
providertotodiscuss
discuss the
the reduction
reduction oror withdrawal
withdrawal of of heparin.
heparin.
Rationale:
Rationale:
Heparin-inducedthrombocytopenia
Heparin-induced thrombocytopenia(HIT)
(HIT)is is a potential
a potential immune-mediated
immune-mediated adverse
adverse effect
effect
infusionsthat
of heparin infusions thatcan
canprove
provefatal.
fatal.HIT
HIT is is suspected
suspected when
when thethe platelet
platelet counts
counts fall fall
A platelet
significantly. A platelet count
countbelow
below100,000/mm3
100,000/mm3would wouldwarrant
warrant discontinuation
discontinuation of of
thethe
heparin.
heparin.
The nurse
The nurseisisready
readytotobegin
begin a heparin
a heparin infusion
infusion for for a patient
a patient withwith evolving
evolving stroke.
stroke.
The baseline
The baselineactivated
activatedpartial
partialthromboplastin
thromboplastin time
time (aPTT)
(aPTT) is seconds.
is 40 40 seconds.
WhichWhich
aPTTvalue
aPTT valueindicates
indicatesthat
thata a therapeutic
therapeutic dose
dose hashas
beenbeen achieved?
achieved?
50
a. 50
70
b. 70
c. 90
c. 90
110
d. 110
70
b. 70
Rationale:
Rationale:
The therapeutic
The therapeuticlevel
levelofofheparin
heparinisisachieved
achieved when
when thethe aPTT
aPTT reaches
reaches 1.5 to1.5 to 2 times
2 times
Thus,aarange
normal. Thus, rangeofof6060toto8080 seconds
seconds would
would be be appropriate
appropriate for for
thisthis patient.
patient.
The nurseisiscaring
The nurse caringforfor a patient
a patient who
who takes
takes warfarin
warfarin [Coumadin]
[Coumadin] for prevention
for prevention of of
deep veinthrombosis.
deep vein thrombosis.The The patient
patient has
has anan international
international normalized
normalized ratio
ratio (INR)
(INR) of of
1.2. Whichaction
1.2. Which actionbybythe
thenurse
nurseis is most
most appropriate?
appropriate?
a. Administer
Administerintravenous
intravenous(IV)
(IV)push
push protamine
protamine sulfate.
sulfate.
b. Continue
Continuewith
withthe
thecurrent
currentprescription.
prescription.
, NURS 323
MIDTERM & FINAL EXAM
ACTUAL Questions with Answers
(Nursing Pharmacology Concepts I)
Drexel University
This Document Description:
• This document contains a collection of Verified
questions with accurate Answers.
• It covers core topics assessed in the course and
reflects the actual exam format and question style.
Ideal for exam preparation and concept reinforcement.
,Table of Contents
MIDTERM EXAM ................................................................... 2
FINAL EXAM ........................................................................ 15
MIDTERM EXAM
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700.
Which action should the nurse take?
A. Take the patient's blood pressure.
B. Give the patient's PRN dose of insulin.
C. Check the patient's capillary blood sugar.
D. Advise the patient to lie down with the legs elevated.
C. Check the patient's capillary blood sugar.
Rationale:
The patient is exhibiting signs of hypoglycemia. Remember that the peak of NPH insulin
can be 6-14 hours after administration.
A teaching plan for a patient who is taking lispro [Humalog] should include which
instruction by the nurse?
A. "Inject this insulin with your first bite of food, because it is very fast acting."
B. "The duration of action for this insulin is about 8 to 10 hours, so you'll need a
snack."
C. "This insulin needs to be mixed with regular insulin to enhance the effects."
D. "To achieve tight glycemic control, this is the only type of insulin you'll need."
A. "Inject this insulin with your first bite of food, because it is very fast acting."
, A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin
normally work in my body?" The nurse explains that normal insulin has which action in
the body?
A. It stimulates the pancreas to reabsorb glucose.
B. It promotes the synthesis of amino acids into glucose.
C. It stimulates the liver to convert glycogen to glucose.
D. It promotes the passage of glucose into cells for energy.
D. It promotes the passage of glucose into cells for energy.
A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is
teaching hypoglycemia awareness and should warn the patient about the presence of
which symptom?
A. Vomiting
B. Muscle cramps
C. Tachycardia
D. Chills
C. Tachycardia
A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin.
Which finding requires immediate follow-up by the nurse?
A. Skin rash
B. Sweating
C. Itching
D. Pedal edema
B. Sweating
Rationale:
Sweating is a manifestation of hypoglycemia, an adverse reaction seen with pramlintide
[Symlin]
Before administering metformin [Glucophage], the nurse should notify the prescriber
about which laboratory value?
