Pharmacology Made Incredibly Easy
5th Edition
• Author(s)Cherie R. Rebar; Nicole M.
Heimgartner; Carolyn Gersch
NCLEX-RN Pharmacology Practice
Questions
Introduction to Pharmacology
,Test Bank
Question 1
Clinical Scenario
A 72-year-old client with osteoarthritis is admitted for dehydration.
During medication reconciliation, the nurse learns that the client takes
acetaminophen 650 mg every 6 hr for arthritis pain. The client also
reports taking an over-the-counter cold medication containing
acetaminophen 500 mg every 6 hr as needed. The client has a history of
chronic alcohol use and mildly elevated liver enzymes.
Question Stem
Which action should the nurse take first?
A. Administer the prescribed acetaminophen and document the over-
the-counter medication.
B. Ask the client to take both medications only when pain is severe.
,C. Identify the total daily acetaminophen intake and notify the provider
of the duplicate therapy.
D. Substitute ibuprofen for the prescribed acetaminophen without
notifying the provider.
Correct Answer
Correct Answer: C. Identify the total daily acetaminophen intake and
notify the provider of the duplicate therapy.
Detailed Rationale
The priority is to determine the client's cumulative acetaminophen
exposure because multiple combination products can unintentionally
result in excessive dosing and increase the risk of hepatotoxicity. The
nurse should review every prescription, over-the-counter product, and
supplement during medication reconciliation rather than evaluating
each medication in isolation. The client's history of chronic alcohol use
and abnormal liver enzymes further increases concern for liver injury.
Option A is incorrect because administering the scheduled dose without
first clarifying the total amount may perpetuate duplicate therapy.
Option B is unsafe because changing the frequency independently does
not address the underlying duplication or establish a safe maximum for
this client. Option D is inappropriate because ibuprofen can increase
gastrointestinal and renal risks, particularly in a dehydrated older adult,
and medication changes require appropriate evaluation and
authorization.
The nurse should teach the client to check active ingredients on
combination products and avoid taking more than one acetaminophen-
containing product unless specifically directed. This case illustrates why
, medication reconciliation is a safety intervention, not merely a
documentation task.
Learning Objective
After completing this question, the learner should be able to:
• Identify duplicate therapy during medication reconciliation.
• Recognize risk factors for medication-related hepatotoxicity.
• Apply safe medication reconciliation principles to over-the-
counter products.
Medication Safety Focus
Medication reconciliation
Question 2
Clinical Scenario
A 24-year-old client with type 1 diabetes mellitus is prescribed insulin
lispro before meals. The nurse prepares the insulin at 11:45 AM. The
client states, “I am not hungry because I feel nauseated,” and the meal
tray has not arrived. The client's blood glucose is 214 mg/dL.
Question Stem
Which action should the nurse take?
A. Administer the insulin now because the blood glucose is elevated.
B. Administer half the prescribed dose.
C. Hold the insulin until the meal is available and the client is ready to
5th Edition
• Author(s)Cherie R. Rebar; Nicole M.
Heimgartner; Carolyn Gersch
NCLEX-RN Pharmacology Practice
Questions
Introduction to Pharmacology
,Test Bank
Question 1
Clinical Scenario
A 72-year-old client with osteoarthritis is admitted for dehydration.
During medication reconciliation, the nurse learns that the client takes
acetaminophen 650 mg every 6 hr for arthritis pain. The client also
reports taking an over-the-counter cold medication containing
acetaminophen 500 mg every 6 hr as needed. The client has a history of
chronic alcohol use and mildly elevated liver enzymes.
Question Stem
Which action should the nurse take first?
A. Administer the prescribed acetaminophen and document the over-
the-counter medication.
B. Ask the client to take both medications only when pain is severe.
,C. Identify the total daily acetaminophen intake and notify the provider
of the duplicate therapy.
D. Substitute ibuprofen for the prescribed acetaminophen without
notifying the provider.
Correct Answer
Correct Answer: C. Identify the total daily acetaminophen intake and
notify the provider of the duplicate therapy.
Detailed Rationale
The priority is to determine the client's cumulative acetaminophen
exposure because multiple combination products can unintentionally
result in excessive dosing and increase the risk of hepatotoxicity. The
nurse should review every prescription, over-the-counter product, and
supplement during medication reconciliation rather than evaluating
each medication in isolation. The client's history of chronic alcohol use
and abnormal liver enzymes further increases concern for liver injury.
Option A is incorrect because administering the scheduled dose without
first clarifying the total amount may perpetuate duplicate therapy.
Option B is unsafe because changing the frequency independently does
not address the underlying duplication or establish a safe maximum for
this client. Option D is inappropriate because ibuprofen can increase
gastrointestinal and renal risks, particularly in a dehydrated older adult,
and medication changes require appropriate evaluation and
authorization.
The nurse should teach the client to check active ingredients on
combination products and avoid taking more than one acetaminophen-
containing product unless specifically directed. This case illustrates why
, medication reconciliation is a safety intervention, not merely a
documentation task.
Learning Objective
After completing this question, the learner should be able to:
• Identify duplicate therapy during medication reconciliation.
• Recognize risk factors for medication-related hepatotoxicity.
• Apply safe medication reconciliation principles to over-the-
counter products.
Medication Safety Focus
Medication reconciliation
Question 2
Clinical Scenario
A 24-year-old client with type 1 diabetes mellitus is prescribed insulin
lispro before meals. The nurse prepares the insulin at 11:45 AM. The
client states, “I am not hungry because I feel nauseated,” and the meal
tray has not arrived. The client's blood glucose is 214 mg/dL.
Question Stem
Which action should the nurse take?
A. Administer the insulin now because the blood glucose is elevated.
B. Administer half the prescribed dose.
C. Hold the insulin until the meal is available and the client is ready to
